Introduction: This study aims to assess the relationship between the modified Mallet classification and the Brachial Plexus Profile activity short form (BP-PRO activity SF). The therapist or surgeon classifies upper extremity movement for the modified Mallet classification, while the BP-PRO assesses parents' perceptions of difficulty performing activities.
Purpose: To provide a deeper understanding of the relationship of functional and perceived outcome measurements.
Study Design: Prospective, correlational design.
Methods: Eighty children with brachial plexus birth injuries were evaluated using the modified Mallet classification, while parents simultaneously answered the BP-PRO activity SF questions. All patients had undergone one of three surgical interventions to improve shoulder function. The relationship between the two measures, patient injury levels, and surgical histories were assessed.
Results: The average modified Mallet scores and BP-PRO activity SF scores weakly correlated (r = 0.312, P = .005) and both measures differentiated between C5-6 and C5-7 injury levels (P = .03 and P = .02, respectively). Conversely, the modified Mallet scores could differentiate between the three surgical groups (F = 8.2, P < .001), while the BP-PRO activity SF could not (P = .54).
Conclusion: The results suggest that these tools measure different aspects of patient outcomes. The Mallet classification may be more focused on shoulder motion than the BP-PRO activity SF. Additional questions that specifically require shoulder function could be incorporated into the BP-PRO activity SF to improve understanding of patient/parent perceptions of shoulder function for children with brachial plexus injuries. Clinicians should be aware of the strengths, weaknesses, and limitations of each outcome assessment tool for appropriate use and interpretation of results.
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http://dx.doi.org/10.1016/j.jht.2020.10.003 | DOI Listing |
BMC Musculoskelet Disord
November 2024
Orthopedic and Trauma Surgery, Cairo University, Cairo City, Egypt.
Background: Deficient shoulder function is a common and exhausting issue in children with obstetric brachial plexus injuries. Even with functioning elbow, wrist, and fingers, upper limb function is markedly disabled by limited shoulder abduction external rotation. Lower trapezius transfer carries many advantages; simple and safe technique, same line of pull as donor; reliable nerve supply (extraplexal from spinal accessory nerve), and not acting on rotation of the shoulder, mostly it will not adversely affect internal rotation range after the transfer.
View Article and Find Full Text PDFJ Hand Surg Am
November 2024
Department of Orthopedics and Traumatology, Hacettepe University, Ankara, Turkey.
Purpose: In brachial plexus birth injury (BPBI), children with upper trunk injuries have multidirectional movement deficits, including global abduction and hand-to-neck, hand-to-abdomen, and hand-to-spine movements. The aim of this study was to evaluate the results of pericoracoid tissue release and postoperative structured physiotherapy as a first-step intervention to reduce the multidirectional movement deficit in children with BPBI.
Methods: Thirty-four children with BPBI underwent pericoracoid tissue release, including coracohumeral and coracoacromial ligament release, pectoralis minor release, and coracoid process osteotomy.
PLoS Biol
September 2024
Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America.
J Shoulder Elbow Surg
August 2024
Department of Orthopedic Surgery, Shriners Children's, Philadelphia, PA, USA.
Background: Tendon transfers are often utilized to improve shoulder external rotation and abduction in children with brachial plexus birth injuries and are designed to improve glenohumeral (GH) joint motion. However, changes in scapulothoracic (ST) and GH joint function after tendon transfer are not well defined. The purpose of this study was to quantify changes in GH, ST, and humerothoracic (HT) joint function before and after tendon transfer, and we hypothesized that tendon transfers would reorient the arc of motion into more external rotation and abduction, but not increase GH motion.
View Article and Find Full Text PDFJ Pediatr Orthop
October 2024
Department of Orthopedic Surgery, Shriners Hospitals for Children, Philadelphia, PA.
Background: Brachial plexus birth injuries (BPBI) occur in up 0.4 to 4.6 per 1000 live births.
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