Degree of Contracture Related to Residual Muscle Shoulder Strength in Children with Obstetric Brachial Plexus Lesions.
| Autor: | van Gelein Vitringa VM; Department of Orthopaedic Surgery, VU Medical Center, Amsterdam, The Netherlands., van Noort A; Department of Orthopaedic Surgery, Spaarne Ziekenhuis, Hoofddorp, The Netherlands., Ritt MJ; Department of Plastic Surgery, VU Medical Center, Amsterdam, The Netherlands., van Royen BJ; Department of Orthopaedic Surgery, VU Medical Center, Amsterdam, The Netherlands., van der Sluijs JA; Department of Orthopaedic Surgery, VU Medical Center, Amsterdam, The Netherlands. |
|---|---|
| Jazyk: | angličtina |
| Zdroj: | Journal of brachial plexus and peripheral nerve injury [J Brachial Plex Peripher Nerve Inj] 2015 Aug 05; Vol. 10 (1), pp. e23-e29. Date of Electronic Publication: 2015 Aug 05 (Print Publication: 2015). |
| DOI: | 10.1055/s-0035-1558425 |
| Abstrakt: | Background and Objectives: Little is known about the relation between residual muscle strength and joint contracture formation in neuromuscular disorders. This study aimed to investigate the relation between residual muscle strength and shoulder joint contractures in children with sequelae of obstetric brachial plexus lesion (OBPL). In OBPL a shoulder joint contracture is a frequent finding. We hypothesize that residual internal and external rotator strength and their balance are related to the extent of shoulder joint contracture. Methods: Clinical assessment was performed in 34 children (mean 10.0 years) with unilateral OBPL and Narakas classes I-III. External and internal rotation strengths were measured with the shoulder in neutral position using a handheld dynamometer. Strength on the affected side was given as percentage of the normal side. Contracture was assessed by passive internal and external rotations in degrees (in 0° abduction). Mallet classification was used for active shoulder function. Results: External and internal rotation strengths on the affected side were approximately 50% of the normal side and on average both equally affected: 56% (SD 18%) respectively 51% (SD 27%); r = 0.600, p = 0.000. Residual strengths were not related to passive internal or external rotation ( p > 0.200). Internal rotation strength ( r = - 0.425, p <0.05) was related to Narakas class. Mallet score was related to external and internal rotation strengths ( r = 0.451 and r = 0.515, respectively; p < 0.01). Conclusion: The intuitive notion that imbalances in residual muscle strength influence contracture formation cannot be confirmed in this study. Our results are of interest for the understanding of contracture formation in OBPL. |
| Databáze: | MEDLINE |
| Externí odkaz: |
|