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Change in shoulder external rotation strength and motion after lower trapezius transfer to the infraspinatus in children with obstetric brachial plexus palsy

Abstract

Purpose

Quantifying changes in shoulder external rotation range of motion and strength after lower trapezius transfer in children with obstetric brachial plexus palsy (OBPP).

Methods

This prospective study included five children with sequelae of OBPP, with a mean age of 6.4 years (range: 4–12 years) who underwent lower trapezius tendon transfer to restore active external rotation (ER) of the shoulder. Pre-operatively and at a 12-month follow-up assessment, we analyzed the passive and active shoulder ER, the modified Mallet score, and the shoulder rotator muscles strength using an isokinetic device.

Results

Clinical parameters improved significantly after trapezius transfer pre-operative passive ER from −8° (range: −20–0°) to 37° (range: 15–50°) (p = 0.035), the modified Mallet score from 13 (range: 10–15) to 18 (range: 17–19) (p = 0.035). Strength testing revealed improved ER muscle strength in all five cases; the mean Peak Torque increased from 1.95 to 4.46 N·m, albeit non-significantly (p = 0.062). Two patients exhibited a winged scapula post-operatively.

Conclusion

Lower trapezius transfer seems encouraging to restore shoulder external rotation in OBPP children but with non-significant strength improvement.

Trial registration

18/07/31/5783, December 22, 2018

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Author information

Affiliations

Authors

Contributions

All authors contributed to the study conception and design. Conceptualization: Bertrand Coulet, Isabelle Laffont, Jérôme Cottalorda; material preparation, data collection, and analysis: Charline Garçon, Hicham Abdelnour, Marion Delpont, Karen Lambert; first draft of the manuscript: Charline Garçon, Hicham Abdelnour; writing review: Djamel Louahem, Marion Delpont, Jérôme Cottalorda, Karen Lambert. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Marion Delpont.

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Level of evidence: IV (case series)

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Cite this article

Garcon, C., Abdelnour, H., Jeandel, C. et al. Change in shoulder external rotation strength and motion after lower trapezius transfer to the infraspinatus in children with obstetric brachial plexus palsy. International Orthopaedics (SICOT) 45, 3163–3170 (2021). https://doi.org/10.1007/s00264-021-05247-3

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Keywords

  • Lower trapezius transfer
  • Obstetric palsy
  • Isokinetic
  • Muscle strength
  • Muscle transfer
  • Children