Article

There is little information about the range of motion (ROM) and
strength of the affected upper limbs of patients with permanent brachial plexus
birth palsy. PATIENTS AND METHODS: 107 patients who had brachial plexus surgery
in Finland between 1971 and 1998 were investigated in this population-based,
cross-sectional, 12-year follow-up study. During the follow-up, 59 patients
underwent secondary procedures. ROM and isometric strength of the shoulders,
elbows, wrists, and thumbs were measured. Ratios for ROM and strength between the
affected and unaffected sides were calculated. RESULTS: 61 patients (57%) had no
active shoulder external rotation (median 0 degrees (-75-90)). Median active
abduction was 90 degrees (1-170). Shoulder external rotation strength of the
affected side was diminished (median ratio 28% (0-83)). Active elbow extension
deficiency was recorded in 82 patients (median 25 degrees (5-80)). Elbow flexion
strength of the affected side was uniformly impaired (median ratio 43% (0-79)).
Median active extension of the wrist was 55 degrees (-70-90). The median ratio of
grip strength for the affected side vs. the unaffected side was 68% (0-121).
Patients with total injury had poorer ROM and strength than those with C5-6
injury. Incongruity of the radiohumeral joint and avulsion were associated with
poor strength values. INTERPRETATION: ROM and strength of affected upper limbs of
patients with surgically treated brachial plexus birth palsy were reduced.
Patients with avulsion injuries and/or consequent joint deformities fared worst.

Langue : ANGLAIS