Assessment and treatment of glenohumeral joint deformities in children suffering from upper obstetric brachial plexus palsy.

Abstract

We present our approach to gleno-humeral joint deformities as sequelae from severe upper obstetric brachial plexus palsy. In 50 consecutive children with severe medial rotation contracture of the shoulder after obstetric brachial plexus palsy, we used magnetic resonance imaging to evaluate joint incongruence and dysplasia; showing frequently various deformities of the glenoid, the humeral head and pathologic changes in their relationship. The most severe deformity is true glenohumeral dysplasia. These diagnostic findings might influence our choice and technical details within surgical procedures. We actually evaluate image processing tools (segmentation software) for a better understanding of changes in anatomical structures responsible for this multifactorial joint deformity, limiting lateral and/or medial rotation of the glenohumeral joint in children with obstetric brachial plexus palsy.