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1. Background
Obstetric brachial plexus palsy (OBPP) refers to upper limb paralysis secondary to a sustained traction or compression injury to the brachial plexus during birth. The reported incidence in developed countries is 2 per 1000 live births (1). Risk factors for OBPP include shoulder dystocia, high gestational age, forceps delivery, and clavicle fracture. The shoulder dystocia has been identified as the greatest risk factor (2). Although 96% recover spontaneously, a subset of individuals demonstrate persistent neurological and functional deficits due to muscle weakness, soft tissue contractures, and structural deformities.
The assessment and planning of appropriate treatment is important in the early stages of OBPP. Conservative and surgical treatment approaches are not alternative, but complementary to each other. Conservative and surgical treatments both aim to improve the functional level of the organ.
Modified Hoffman technique is used to increase shoulder abduction and external rotation in children with OBPP. After this surgery technique, despite that patients have increased abduction and external rotation, they do not prefer to use the upper limb in their daily living activities (3).
2. Objectives
The aim of our study was to examine the relationship between the range of motion and upper extremity function of the shoulder in patients with OBPP who were treated with tendon transfer.
3. Methods
A total of 57 patients with OBPP were invited for this cross sectional study. Five patients refused to participate in the study. Four assessments were incomplete and were omitted. Therefore, the study completed with 48 patients (20 girls and 28 boys).
The mean age was 6.1 ± 1.4 years and birth weight 4210 ± 496.91 kg. In 26 patients right side was involved and 22 patients had left side involvement. In 17 (35.4 %) patients the palsy was of C5-6 type, in 30 (62.5 %) patients of C5-7, and in 1 (2.1 %) patient of C5-T1.
Children 4 - 8 years of age had underwent an operation useing Modified Hoffer Tecnnigue at least 6 month ago. This technique is used to increase shoulder abduction and external rotation with latissimus dorsi and teres major transfers to strengthen external rotation combined with subscapularis lengthening, reduction of posterior dislocation or subluxation, and humeral osteotomy, if necessary (3-5).
3.1. Assessment
3.1.1. Demographic Characteristics
The medical history of...