Arm rotated medially with supination - the ARMS deformity: Description of its surgical correction
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چکیده
Background Patients who have suffered obstetric brachial plexus injury (OBPI) have a high incidence of musculoskeletal complications stemming from the initial nerve injury. The presence of muscle imbalances and contractures leads to typical bony changes affecting the shoulder, known collectively as the SHEAR (Scapular Hypoplasia, Elevation and Rotation) deformity. The SHEAR deformity commonly occurs in conjunction with Medial Rotation Contracture (MRC) of the arm. OBPI also causes muscle imbalances at the level of the forearm, that lead to a fixed supination deformity (SD) in a small number of patients. Both MRC and SD will cause severe functional limitations without surgical intervention. Methods Fourteen OBPI patients were diagnosed with both MRC of the shoulder and supination deformity of the forearm during a 16 month study period, with eight patients available to long-term follow-up (age range 2.2 18 years). Surgical correction of the MRC was performed as a triangle tilt or humeral osteotomy depending on the age of the child, after which, the patients were treated with a radial osteotomy to correct the fixed supination deformity. Function was assessed using the modified Mallet scale,examination of supination and appearance of the extremity at rest. Results Significant functional improvements were observed in patients with surgical reconstruction. Mallet score increased by an average of 5.2 (p<0.05). Overall forearm position was not significantly changed from an average of 5° to an average of 34°
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Author's response to reviews Title: Arm rotated medially with supination - the ARMS deformity: Description of its surgical correction Authors:
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Arm rotated medially with supination – the ARMS variant: description of its surgical correction
BACKGROUND Patients who have suffered obstetric brachial plexus injury (OBPI) have a high incidence of musculoskeletal complications stemming from the initial nerve injury. The presence of muscle imbalances and contractures leads to typical bony changes affecting the shoulder, including the SHEAR (Scapular Hypoplasia, Elevation and Rotation) deformity. The SHEAR deformity commonly occurs in con...
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