Incidence of early posterior shoulder dislocation in brachial plexus birth palsy^[*]

Abstract

Background Posterior dislocation of the shoulder in brachial plexus birth palsy during the first year of life is rare but the incidence increases with age. The aim was to calculate the incidence of these lesions in children below one year of age.

Methods The incidence of brachial plexus birth lesion and occurrence of posterior shoulder dislocation was calculated based on a prospective follow up of all brachial plexus patients at an age below one in Malmö municipality, Sweden, 2000–2005.

Results The incidence of brachial plexus birth palsy was 3.8/1000 living infants and year with a corresponding incidence of posterior shoulder dislocation (history, clinical examination and x-ray) during the first year of 0.28/1000 living infants and year, i.e. 7.3% of all brachial plexus birth palsies.

Conclusion All children with a brachial plexus birth lesion (incidence 3.8‰) should be screened, above the assessment of neurological recovery, during the first year of life for posterior dislocation of the shoulder (incidence 0.28‰) since such a condition may occur in 7% of children with a brachial plexus birth lesion.

^*This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

• References

• 1 Bager B. Perinatally acquired brachial plexus palsy–a persisting challenge. Acta Paediatr 1997; 86: 1214-1219 9401516
• 2 Mollberg M, Wennergren M, Bager B, Ladfors L, Hagberg H. Obstetric brachial plexus palsy: a prospective study on risk factors related to manual assistance during the second stage of labor. Acta Obstet Gynecol Scand 2007; 86: 198-204 10.1080/00016340601089792 17364283
• 3 Sjoberg I, Erichs K, Bjerre I. Cause and effect of obstetric (neonatal) brachial plexus palsy. Acta Paediatr Scand 1988; 77: 357-364 3389127
• 4 Waters PM, Smith GR, Jaramillo D. Glenohumeral deformity secondary to brachial plexus birth palsy. J Bone Joint Surg Am 1998; 80: 668-677 9611027
• 5 Moukoko D, Ezaki M, Wilkes D, Carter P. Posterior shoulder dislocation in infants with neonatal brachial plexus palsy. J Bone Joint Surg Am 2004; 86-A: 787-793 15069145
• 6 Kambhampati SB, Birch R, Cobiella C, Chen L. Posterior subluxation and dislocation of the shoulder in obstetric brachial plexus palsy. J Bone Joint Surg Br 2006; 88: 213-219 16434527
• 7 Kozin SH. Correlation between external rotation of the glenohumeral joint and deformity after brachial plexus birth palsy. J Pediatr Orthop 2004; 24: 189-193 15076606
• 8 Pearl ML, Edgerton BW, Kazimiroff PA, Burchette RJ, Wong K. Arthroscopic release and latissimus dorsi transfer for shoulder internal rotation contractures and glenohumeral deformity secondary to brachial plexus birth palsy. J Bone Joint Surg Am 2006; 88: 564-574 10.2106/JBJS.D.02872 16510824
• 9 Pearl ML, Edgerton BW, Kon DS, Darakjian AB, Kosco AE, Kazimiroff PB, Burchette RJ. Comparison of arthroscopic findings with magnetic resonance imaging and arthrography in children with glenohumeral deformities secondary to brachial plexus birth palsy. J Bone Joint Surg Am 2003; 85-A: 890-898 12728041
• 10 Mollberg M, Hagberg H, Bager B, Lilja H, Ladfors L. Risk factors for obstetric brachial plexus palsy among neonates delivered by vacuum extraction. Obstet Gynecol 2005; 106: 913-918 16260506
• 11 Birch R. Obstetric brachial plexus palsy. In: Gupta A, Kay SP, Scheker LR. The growing hand Diagnosis and management of the upper extremity in children. Mosby; 2000: 461-474
• 12 Broker FH, Burbach T. Ultrasonic diagnosis of separation of the proximal humeral epiphysis in the newborn. J Bone Joint Surg Am 1990; 72: 187-191 2406274
• 13 van der Sluijs JA, van Ouwerkerk WJ, de Gast A, Wuisman PI, Nollet F, Manoliu RA. Deformities of the shoulder in infants younger than 12 months with an obstetric lesion of the brachial plexus. J Bone Joint Surg Br 2001; 83: 551-555 10.1302/0301-620X.83B4.11205 11380130
• 14 Scaglietti O. The obstetrical shoulder trauma. Surg Gynecol Obstet 1938; 868-877
• 15 Goddard NJ, Fixsen JA. Rotation osteotomy of the humerus for birth injuries of the brachial plexus. J Bone Joint Surg Br 1984; 66: 257-259 6707064
• 16 Whitman R. VIII. The treatment of congenital and acquired luxations at the shoulder in childhood. Ann Surg 1905; 42 (1) 110-115 1425937 17861655 10.1097/00000658-190507000-00008
• 17 Fairbank HAT. Birth palsy: A lecture on subluxation of the shoulder-joint in infants and young children. Lancet 1913; 1217-1223
• 18 Phelps AM. Report of a case of congenital dislocation of the shoulder backward. Trans Am Orthop Assn 1896; 8: 239-245
• 19 Sever JW. Obstetrical paralysis: report of eleven hundred cases. JAMA 1925; 85: 1862-1865
• 20 Troum S, Floyd 3rd WE, Waters PM. Posterior dislocation of the humeral head in infancy associated with obstetrical paralysis. A case report. J Bone Joint Surg Am 1993; 75: 1370-1375 8408159
• 21 Alm B, Wennergren G, Erdes L, Mollborg P, Pettersson R, Aberg N, Norvenius SG. [Parents have accepted the advice on how to prevent sudden infant death]. Lakartidningen 2004; 101: 1268-1270 15101212