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Children's Orthopaedics: J. M. Kirkos, M. J. Kyrkos, G. A. Kapetanos, and J. H. Haritidis Brachial plexus palsy secondary to birth injuries: LONG-TERM RESULTS OF ANTERIOR RELEASE AND TENDON TRANSFERS AROUND THE SHOULDER J Bone Joint Surg Br 2005; 87-B: 231-235 [Abstract] [Full text] [PDF]

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Re: Osteoarthritis of shoulder after obstetric brachial plexus palsy

John M. Kirkos   (9 January 2006)

Osteoarthritis of shoulder after obstetric brachial plexus palsy

William W Williams   (26 October 2005)

Re: Osteoarthritis of shoulder after obstetric brachial plexus palsy 9 January 2006
John M. Kirkos, Assoc. Professor in Orthopaedic Surgery Aristotle University of Thessaloniki, Greece Send letter to journal: Re: Re: Osteoarthritis of shoulder after obstetric brachial plexus palsy mjkyrkos{at}hotmail.com John M. Kirkos	Dear Sir, We thank Mr. Williams for his interest in our paper. We agree that osteoarthritis of the shoulder in Erb’s palsy is an extremely rare entity. It is so rare that, to the best of our knowledge, there is only a single reference in the literature.1 This is why we use the term 'degenerative changes' in our paper. As we mentioned, a gradual decrease of both active and passive movements of the shoulder joint was noticed throughout the decades of follow-up. This gradual decrease in all rotational movement of the shoulder during follow-up is attributed to the shrinking of the surrounding soft tissues, the deformity, and the degenerative changes affecting the humeral head. Moreover, narrowing of the joint space, sclerosis and degenerative changes of the humeral head (which in our opinion appear in Fig. 2c) are signs of osteoarthritic changes. Therefore we believe that our stated clinical and radiological findings permit us to use the term osteoarthritis. John M. Kirkos, MD, Aristotle University, Thessaloniki, Greece 1. Gosens T, Neuman L, Wallace A. Shoulder replacement after Erb’s palsy: A case report with ten years’ follow-up. J Shoulder Elbow Surg 2004;13:568-572.
Osteoarthritis of shoulder after obstetric brachial plexus palsy 26 October 2005
William W Williams, Consultant Orthopaedic Surgeon Send letter to journal: Re: Osteoarthritis of shoulder after obstetric brachial plexus palsy williams132{at}aol.com William W Williams	Sir, I read this article with great interest. The authors comment that five of the ten patients developed osteoarthritis of their shoulder. The illustration (figure 2) does not demonstrate this clearly. Would the authors be able to explain how they made this diagnosis, because this is the first reference to the development of osteoarthritis in this group of patients. Prior to this it was believed that the shoulder did not develop osteoarthritis after obstetric brachial plexus palsy. William Williams FRCS, FRCS(Orth) Broomfield Hospital, Chelmsford, UK