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Journal of Bone and Joint Surgery - British Volume, Vol 89-B, Issue 12,
1638-1644.
doi: 10.1302/0301-620X.89B12.18757 Copyright © 2007 by British Editorial Society of Bone and Joint Surgery Surgical correction of the medial rotation contracture in obstetric brachial plexus palsyR. K. Nath, MD, Plastic and Reconstructive Surgeon1; A. B. Lyons, BSc, Research Assistant1; S. E. Melcher, BA, Research Scientist1; and M. Paizi, DSc, Research Scientist11 Texas Nerve and Paralysis Institute, 2201 W. Holcombe Boulevard, Houston, Texas 77030, USA. Correspondence should be sent to Dr R. K. Nath; e-mail: nath{at}drnathmedical.com
The medial rotation contracture caused by weak external rotation secondary to obstetric brachial plexus injury leads to deformation of the bones of the shoulder. Scapular hypoplasia, elevation and rotation deformity are accompanied by progressive dislocation of the humeral head. Between February and August 2005, 44 children underwent a new surgical procedure called the ‘triangle tilt’ operation to correct this bony shoulder deformity. Surgical levelling of the distal acromioclavicular triangle combined with tightening of the posterior glenohumeral capsule (capsulorrhaphy) improved shoulder function and corrected the glenohumeral axis in these patients. The posture of the arm at rest was improved and active external rotation increased by a mean of 53° (0° to 115°) in the 40 children who were followed up for more than one year. There was a mean improvement of 4.9 points (1.7 to 8.3) of the Mallet shoulder function score after surgical correction of the bony deformity. This article has been cited by other articles:
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