Humeral internal rotation osteotomy for the treatment of Erb-Duchenne-type obstetric palsy: clinical and radiographic results

Clinics (Sao Paulo). 2013 Jul;68(7):928-33. doi: 10.6061/clinics/2013(07)07.

Abstract

Objective: To evaluate the functional and radiographic results in patients undergoing shoulder anterior soft tissue stretching in association with open reduction and internal rotation osteotomy to centralize the humeral head as a treatment for Erb-Duchenne obstetric palsy sequelae.

Method: A total of 35 patients underwent this surgical treatment, and the mean follow-up was 4.6 years. The Mallet scale was applied before and after the surgical procedure. A total of 20 patients underwent computed tomography to assess the glenoid version and humeral head subluxation.

Results: Functional improvement was achieved, as evidenced by an increase in the Mallet scale score from 12.14 to 16.46 (p<0.001). The correction of retroversion was achieved once the glenoid version ranged from -21.4 to -12 degrees (p<0.001). The humeral head subluxation improved from 6.5 to 35.2% (p<0.001). Patients older than 6 years of age did not achieve glenohumeral joint improvement with respect to dysplastic abnormalities.

Conclusion: Internal rotation osteotomy in association with the stretching of anterior soft tissues of the shoulder in patients under the age of 7 years provided improvements in the function, retroversion, and subluxation of the glenohumeral joint.

Publication types

  • Evaluation Study

MeSH terms

  • Age Factors
  • Brachial Plexus Neuropathies / diagnostic imaging
  • Brachial Plexus Neuropathies / surgery*
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Humans
  • Humeral Head / diagnostic imaging
  • Humeral Head / surgery*
  • Infant
  • Male
  • Osteotomy / methods*
  • Postoperative Period
  • Preoperative Period
  • Recovery of Function
  • Rotation
  • Shoulder Joint / diagnostic imaging
  • Shoulder Joint / surgery
  • Tomography, X-Ray Computed
  • Treatment Outcome