Birth weight and incidence of surgical obstetric brachial plexus injury.

Objectives: (1) To analyze the birth weight of obstetric brachial plexus injury (OBPI) patients requiring one or more reconstructive surgeries and (2) to analyze whether there is any difference in the severity of the injury, and the outcome of the surgery between the macrosomic and nonmacrosomic OBPI patients.

Study Design: An observational cohort study was performed on 100 consecutive patients treated with surgery at the Texas Nerve and Paralysis Institute. Ninety of the 100 patients underwent the modified Quad surgery, which improves the shoulder abduction and overall shoulder function.

Risk factors at birth for permanent obstetric brachial plexus injury and associated osseous deformities.

Purpose. To examine the most prevalent risk factors found in patients with permanent obstetric brachial plexus injury (OBPI) to identify better predictors of injury. Methods.

Surgical normalization of the shoulder joint in obstetric brachial plexus injury.

Obstetric brachial plexus injuries (OBPI) result in bony derangements that include posterior humeral head subluxation, glenoid retroversion, and joint incongruity. Often these deformities are accompanied by scapular hypoplasia, elevation, and rotation, which further exacerbate shoulder dysfunction. The purpose of the current study was to investigate the effects of triangle tilt surgery on glenohumeral joint anatomy in 100 OBPI patients.

Structure of the three-way helical junction of the hepatitis C virus IRES element.

The hepatitis C virus internal ribosome entry site (IRES) element contains a three-way junction that is important in the overall RNA conformation, and for its role in the internal initiation of translation. The junction also illustrates some important conformational principles in the folding of three-way helical junctions. It is formally a 3HS(4) junction, with the possibility of two alternative stacking conformers.

Long-term outcomes of triangle tilt surgery for obstetric brachial plexus injury.

Aim: The purpose of this study was to evaluate long-term shoulder functional outcomes from a triangle tilt procedure on obstetric patients, who initially presented with medial rotation contracture and scapular deformity secondary to obstetric brachial plexus injury.

Methods: We retrospectively studied long-term outcomes both functionally and anatomically in 61 patients (age ranging from 2 to 12 years). Functional movements were evaluated and scored using a modified Mallet scale at different time intervals: preoperatively, 1 year and 2 year following triangle tilt surgery.

Triangle tilt surgery in an older pediatric patient with obstetric brachial plexus injury.

Children with an obstetric brachial plexus injury have an elevated risk of long-term impairment if they do not fully recover by the age of 3 months. Persistent nerve damage leads to muscle abnormalities and progressive muscle and bone deformities. Several procedures have been described to treat this severe deformity.

Arm rotated medially with supination - the ARMS variant: description of its surgical correction.

Background: Patients who have suffered obstetric brachial plexus injury (OBPI) have a high incidence of musculoskeletal complications stemming from the initial nerve injury. The presence of muscle imbalances and contractures leads to typical bony changes affecting the shoulder, including the SHEAR (Scapular Hypoplasia, Elevation and Rotation) deformity. The SHEAR deformity commonly occurs in conjunction with Medial Rotation Contracture (MRC) of the arm.

Upright MRI of glenohumeral dysplasia following obstetric brachial plexus injury.

The purpose of this study was to evaluate the role of upright magnetic resonance imaging (MRI) shoulder scanning in the diagnosis of glenohumeral deformity following obstetric brachial plexus injury (OBPI). Eighty-nine children (ages 0.4 to 17.

Rapid recovery of serratus anterior muscle function after microneurolysis of long thoracic nerve injury.

Background: Injury to the long thoracic nerve is a common cause of winging scapula. When the serratus anterior muscle is unable to function, patients often lose the ability to raise their arm overhead on the affected side.

Methods: Serratus anterior function was restored through decompression, neurolysis, and tetanic electrical stimulation of the long thoracic nerve.

Surgical correction of unsuccessful derotational humeral osteotomy in obstetric brachial plexus palsy: evidence of the significance of scapular deformity in the pathophysiology of the medial rotation contracture.

Background: The current method of treatment for persistent internal rotation due to the medial rotation contracture in patients with obstetric brachial plexus injury is humeral derotational osteotomy. While this procedure places the arm in a more functional position, it does not attend to the abnormal glenohumeral joint. Poor positioning of the humeral head secondary to elevation and rotation of the scapula and elongated acromion impingement causes functional limitations which are not addressed by derotation of the humerus.

Induced fit of RNA on binding the L7Ae protein to the kink-turn motif.

The kink-turn is a widespread motif in RNA consisting of a three-nucleotide bulge flanked on one side by consecutive A3G mismatches. Important examples are found in the ribosome, U4 RNA, and in snoRNAs involved in RNA modification. The motif is a common protein binding site, and the RNA has been found to adopt a tightly kinked conformation in crystal structures.

The kink-turn motif in RNA is dimorphic, and metal ion-dependent.

The kink-turn (K-turn) is a new motif in RNA structure that was identified by examination of the crystal structures of the ribosome. We examined the structural and dynamic properties of this element in free solution. The K-turn RNA exists in a dynamic equilibrium between a tightly kinked conformation and a more open structure similar to a simple bulge bend.

The dynamic nature of the four-way junction of the hepatitis C virus IRES.

Translation is initiated within the RNA of the hepatitis C virus at the internal ribosome entry site (IRES). The IRES is a 341-nucleotide element that contains a four-way helical junction (IIIabc) as a functionally important element of the secondary structure. The junction has three additional, nonpaired nucleotides at the point of strand exchange on one diagonal.