HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kon, D. S. Articles by Kosco, A. E. Search for Related Content PubMed PubMed Citation Articles by Kon, D. S. Articles by Kosco, A. E.

Glenohumeral Deformity in Children with Internal Rotation Contractures Secondary to Brachial Plexus Birth Palsy: Intraoperative Arthrographic Classification¹

¹ From the Department of Diagnostic Imaging, Kaiser Permanente Los Angeles Medical Center, Los Angeles, Calif. From the 1999 RSNA scientific assembly. Received August 26, 2002; revision requested October 24; final revision received November 17, 2003; accepted January 5, 2004. Address correspondence to D.S.K., Department of Radiology, USC Medical Center, 1200 N State St, Suite 3550, Los Angeles, CA 90033 (e-mail: darissa@juno.com).

PURPOSE: To evaluate, with intraoperative arthrography, joint morphology in children undergoing surgical treatment of residual paralysis of the shoulder resulting in brachial plexus birth palsy and to correlate the morphology with the degree of passive external rotation.

MATERIALS AND METHODS: In 64 children (age range, 7 months to 13 years 6 months), an orthopedic surgeon performed intraoperative arthrography and measured passive external rotation while the patient received a general anesthetic. The orthopedic surgeon and three radiologists reviewed arthrograms and in consensus classified glenohumeral joints in one of four categories: concentric, with the humeral head well centered on the glenoid fossa; flat, with flattening of the posterior glenoid; biconcave, with the humeral head in articulation with the posterior of two concavities, which were in the same plane; and pseudoglenoid, with the humeral head in articulation with the more posterior of two concavities, with retroversion and in a plane different from that of the anterior concavity. Kruskal-Wallis test was used to compare preoperative external rotation with four appearances of glenoid.

RESULTS: Twenty-one children had concentric glenohumeral joints; seven children, flat glenohumeral joints; 19 children, biconcave glenoid; and 17 children, pseudoglenoid. Median passive external rotation was –20° for patients with pseudoglenoid, –10° for those with flat or biconcave glenoids, and 0° for those with concentric glenoids. Presence and type of glenoid deformity were significantly associated with severity of internal rotation contracture (P < .001).

CONCLUSION: Consistent patterns of glenohumeral joint deformity in brachial plexus birth palsy were identified and correlated with severity of internal rotation contracture.

© RSNA, 2004

Index terms: Brachial plexus, 276.492 • Children, skeletal system, 41.42 • Infants, skeletal system, 41.42 • Shoulder, abnormalities, 41.42 • Shoulder, arthrography, 41.122

This article has been cited by other articles:

				R. K. Nath and X. Liu Nerve reconstruction in patients with obstetric brachial plexus injury results in worsening of glenohumeral deformity: A CASE-CONTROL STUDY OF 75 PATIENTS J Bone Joint Surg Br, May 1, 2009; 91-B(5): 649 - 654. [Abstract] [Full Text] [PDF]

				M. L. Pearl Shoulder Problems in Children With Brachial Plexus Birth Palsy: Evaluation and Management J. Am. Acad. Ortho. Surg., April 1, 2009; 17(4): 242 - 254. [Abstract] [Full Text] [PDF]

				M. L. Pearl, B. W. Edgerton, P. A. Kazimiroff, R. J. Burchette, and K. Wong Arthroscopic Release and Latissimus Dorsi Transfer for Shoulder Internal Rotation Contractures and Glenohumeral Deformity Secondary to Brachial Plexus Birth Palsy J. Bone Joint Surg. Am., March 1, 2006; 88(3): 564 - 574. [Abstract] [Full Text] [PDF]