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Oberlin partial ulnar nerve transfer for restoration in obstetric brachial plexus palsy of a newborn: case report.

Shigematsu K, Yajima H, Kobata Y, Kawamura K, Maegawa N, Takakura Y - J Brachial Plex Peripher Nerve Inj (2006)

Bottom Line: An 8 month old male infant with Erb's birth palsy was treated with two peripheral nerve transfers.Forty months after surgery, elbow flexion reached M5 without functional loss of the ulnar nerve.However, at this time partial ulnar nerve transfer for Erb's birth palsy is an optional procedure; a larger number of cases will need to be studied for it to be widely accepted as a standard procedure for Erb's palsy at birth.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Orthopaedic Surgery, Nara Medical University, Nara, Japan. shigema2@naramed-u.ac.jp

ABSTRACT
An 8 month old male infant with Erb's birth palsy was treated with two peripheral nerve transfers. Except for rapid motor reinnervations, elbow flexion was obtained by an Oberlin's partial ulnar nerve transfer, while shoulder abduction was restored by an accessory-to-suprascapular nerve transfer. The initial contraction of the biceps muscle occurred two months after surgery. Forty months after surgery, elbow flexion reached M5 without functional loss of the ulnar nerve. This case demonstrates an excellent result of an Oberlin's nerve transfer for restoration of flexion of the elbow joint in Erb's birth palsy. However, at this time partial ulnar nerve transfer for Erb's birth palsy is an optional procedure; a larger number of cases will need to be studied for it to be widely accepted as a standard procedure for Erb's palsy at birth.

No MeSH data available.


Related in: MedlinePlus

An eight-month-old boy with Erb's palsy at birth had no shoulder abduction or elbow flexion against gravity.
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Figure 1: An eight-month-old boy with Erb's palsy at birth had no shoulder abduction or elbow flexion against gravity.

Mentions: An 8 month old male infant with obstetric brachial plexus palsy associated with a breech delivery (at 40 weeks 1 day, birth weight: 3535 g), was treated by peripheral nerve transfer. He was complicated with phrenic nerve palsy, and a surgical treatment (reefing of the diaphragm) for this lesion had been undertaken at two months of age in another institute. At the first examination in our institute (at 5 months of age), active shoulder abduction and elbow flexion were absent (Fig. 1). Mental and other motor functional developments were normal. During 3 months of observation, no spontaneous recovery of elbow flexion or shoulder abduction was shown. On electrophysiological evaluations, no action potential of the neuromuscular unit was revealed in the biceps and deltoid muscles. The action potential of the neuromuscular unit of the abductor pollicis brevis muscle showed a normal wave. Physical and electrical examinations revealed an upper trunk type (C5-C6) right-side plexopathy. We considered the possibility of spontaneous recovery for several months, but functional recovery was poor. An Oberlin's nerve transfer and an accessory to suprascapular nerve transfer were selected to facilitate a rapid motor functional recovery of the biceps and deltoid muscles.


Oberlin partial ulnar nerve transfer for restoration in obstetric brachial plexus palsy of a newborn: case report.

Shigematsu K, Yajima H, Kobata Y, Kawamura K, Maegawa N, Takakura Y - J Brachial Plex Peripher Nerve Inj (2006)

An eight-month-old boy with Erb's palsy at birth had no shoulder abduction or elbow flexion against gravity.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC1636634&req=5

Figure 1: An eight-month-old boy with Erb's palsy at birth had no shoulder abduction or elbow flexion against gravity.
Mentions: An 8 month old male infant with obstetric brachial plexus palsy associated with a breech delivery (at 40 weeks 1 day, birth weight: 3535 g), was treated by peripheral nerve transfer. He was complicated with phrenic nerve palsy, and a surgical treatment (reefing of the diaphragm) for this lesion had been undertaken at two months of age in another institute. At the first examination in our institute (at 5 months of age), active shoulder abduction and elbow flexion were absent (Fig. 1). Mental and other motor functional developments were normal. During 3 months of observation, no spontaneous recovery of elbow flexion or shoulder abduction was shown. On electrophysiological evaluations, no action potential of the neuromuscular unit was revealed in the biceps and deltoid muscles. The action potential of the neuromuscular unit of the abductor pollicis brevis muscle showed a normal wave. Physical and electrical examinations revealed an upper trunk type (C5-C6) right-side plexopathy. We considered the possibility of spontaneous recovery for several months, but functional recovery was poor. An Oberlin's nerve transfer and an accessory to suprascapular nerve transfer were selected to facilitate a rapid motor functional recovery of the biceps and deltoid muscles.

Bottom Line: An 8 month old male infant with Erb's birth palsy was treated with two peripheral nerve transfers.Forty months after surgery, elbow flexion reached M5 without functional loss of the ulnar nerve.However, at this time partial ulnar nerve transfer for Erb's birth palsy is an optional procedure; a larger number of cases will need to be studied for it to be widely accepted as a standard procedure for Erb's palsy at birth.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Orthopaedic Surgery, Nara Medical University, Nara, Japan. shigema2@naramed-u.ac.jp

ABSTRACT
An 8 month old male infant with Erb's birth palsy was treated with two peripheral nerve transfers. Except for rapid motor reinnervations, elbow flexion was obtained by an Oberlin's partial ulnar nerve transfer, while shoulder abduction was restored by an accessory-to-suprascapular nerve transfer. The initial contraction of the biceps muscle occurred two months after surgery. Forty months after surgery, elbow flexion reached M5 without functional loss of the ulnar nerve. This case demonstrates an excellent result of an Oberlin's nerve transfer for restoration of flexion of the elbow joint in Erb's birth palsy. However, at this time partial ulnar nerve transfer for Erb's birth palsy is an optional procedure; a larger number of cases will need to be studied for it to be widely accepted as a standard procedure for Erb's palsy at birth.

No MeSH data available.


Related in: MedlinePlus