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Open Access Research article

The effect of perinatal brachial plexus lesion on upper limb development

Jerzy Gosk*, Witold Wnukiewicz and Maciej Urban

Author Affiliations

Department of Traumatology, Clinic of Traumatology and Hand Surgery, Wroclaw Medical University, ul. Borowska 213, 50-556 Wrocław, Poland

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BMC Musculoskeletal Disorders 2014, 15:116  doi:10.1186/1471-2474-15-116

Published: 2 April 2014

Abstract

Background

Deficiency in upper limb development is a sequel of the perinatal brachial plexus palsy. The purpose of this study was to evaluate the effect of brachial plexus birth lesion on upper limb development.

Methods

Forty-four patients with unilateral obstetric brachial plexus palsy underwent measurements of both upper extremities. The average age at the time of evaluation was 6.8 years. Active motion was assessed using Gilbert-Raimondi, the modified MRC, and Al-Qattan scales. Paired t test was used for statistical analysis. Correlation between limb length / circumference discrepancy and age / time of surgery was assessed using Pearson correlation coefficient.

Results

A decrease in the circumference and length was observed in all limbs with brachial plexus lesion. We found a statistically significant difference between degree of hand length and width decrease and its useful and useless function. We observed a statistically significant difference in measurement: forearm length, hand length and width dependent on the type of surgical procedure (neurolysis, reconstruction). We observed no correlation between age and limb length / circumference discrepancy. We also observed no correlation between time of surgery and limb length / circumference discrepancy.

Conclusions

The decrease in dimensions of the affected limbs occurred predominantly during the period of early childhood. Disparities in dimensions are observed in both cases of deficiency of useful function of upper limb and cases in which functional efficiency appears.

Keywords:
Brachial plexus palsy; Limb length discrepancy; Limb girth discrepancy; Reconstruction