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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Change history
19 January 2022
A Correction to this paper has been published: https://doi.org/10.1007/s00264-021-05297-7
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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.
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Level of evidence: IV (case series)
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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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DOI: https://doi.org/10.1007/s00264-021-05247-3