External Rotation Predicts Outcomes After Closed Glenohumeral Joint Reduction With Botulinum Toxin Type A in Brachial Plexus Birth Palsy

Journal of Pediatric Orthopedics
Dustin A GreenhillDan A Zlotolow

Abstract

Few studies have investigated outcomes after adjunct botulinum toxin type A (BTX-A) injections into the shoulder internal rotator muscles during shoulder closed reduction and spica cast immobilization in children with brachial plexus birth palsy. The purpose of this study was to report success rates after treatment and identify pretreatment predictors of success. Children with brachial plexus birth palsy who underwent closed glenohumeral joint reduction with BTX-A and casting were included. Minimum follow-up was 1 year. Included patients did not receive concomitant shoulder surgery nor undergo microsurgery within 8 months. Records were reviewed for severity of palsy, age, physical examination scores, passive external rotation (PER), and subsequent orthopaedic procedures (repeat injections, repeat reduction, shoulder tendon transfers, and humeral osteotomy). Treatment success was defined in 3 separate ways: no subsequent surgical reduction, no subsequent closed or surgical reduction, and no subsequent procedure plus adequate external rotation. Forty-nine patients were included. Average age at time of treatment was 11.5 months. Average follow-up was 21.1 months (range, 1 to 9 y). Thirty-two patients (65%) required repeat reductio...Continue Reading

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Citations

Mar 14, 2018·Hand : Official Journal of the American Association for Hand Surgery·Patrick J BuchananHarvey Chim
Feb 14, 2020·Journal of Neuroscience Research·Xiaolin QuLijun Hou
Feb 13, 2019·Journal of Cellular Physiology·Heng LiuShu-Ping Han
Jul 4, 2020·JBJS Reviews·Sandra SchmiegApurva S Shah
Sep 25, 2021·PM & R : the Journal of Injury, Function, and Rehabilitation·Joshua A VovaMatthew J McLaughlin

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