Why the study?
Is humeral retroversion increased in the affected shoulder compared to the normal contralateral shoulder in children with an obstetric brachial plexus lesion?
Is humeral retroversion increased in the affected shoulder compared to the normal contralateral shoulder in children with an obstetric brachial plexus lesion?
Children over 12 months with an obstetric brachial plexus lesion have significantly increased humeral retroversion in the affected shoulder, which is important when considering operative treatment for subluxation.
Increased retroversion may inform preoperative planning for subluxation; hypothesis-generating and requires prospective confirmation in obstetric brachial plexus lesions.
We undertook a prospective MRI study to measure the retroversion of the humeral head in 33 consecutive infants with a mean age of 1 year 10 months (3 months to 7 years 4 months) who had an obstetric brachial plexus lesion (OBPL). According to a standardised MRI protocol both shoulders and humeral condyles were examined and the shape of the glenoid and humeral retroversion determined. The mean humeral retroversion of the affected shoulder was significantly increased compared with the normal contralateral side (−28.4 ± 12.5° v −21.5 ± 15.1°, p = 0.02). This increase was found only in the children over the age of 12 months. In this group humeral retroversion was −29.9 ± 12.9° compared with −19.6 ± 15.6° in the normal shoulder (p = 0.009), giving a mean difference of 10.3° (95% confidence interval 3.3 to 17.3). This finding is of importance when considering the operative treatment for subluxation of the shoulder in children with an OBPL.
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Sluijs et al. (2002) studied this question.
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