<b>Relationship of age and type of obstetric brachial plexus paralysis in forearm pronosupination</b>

Abdouni, Yussef Ali; Checoli, Gabriel Faria; Nascimento, Valdênia das Graças; Costa, Antonio Carlos da; Chakkour, Ivan; Fucs, Patricia Maria de Moraes Barros

doi:10.1016/j.rboe.2017.08.006

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ORIGINAL ARTICLE • Rev. bras. ortop. 52 (5) • Sep-Oct 2017 • https://doi.org/10.1016/j.rboe.2017.08.006 copy

Relationship of age and type of obstetric brachial plexus paralysis in forearm pronosupination ^☆ ☆ Paper developed at Hospital da Irmandade da Santa Casa de São Paulo, Departamento de Ortopedia e Traumatologia, São Paulo, SP, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To evaluate the arc of forearm pronosupination of patients with sequelae of birth paralysis and correlate with these variables.

Methods:

32 children aged between 4 and 14 years with total or partial lesions of the , brachial plexus were evaluated; measurements of pronation and supination, active and passive, were made, both on the injured side and the unaffected side.

Results:

A statistically significant difference was observed between the injured side and the normal side, but there was no difference between the groups regarding age or type of injury.

Conclusion:

The age and type of injury did not impact on the limitation of the forearm pronosupination in children with sequelae of birth paralysis.

Keywords:
Brachial plexus; Obstetric paralysis; Supination; Forearm

	Gender	Age	Type of lesion	PP-injured	PP-normal	AP-injured	AP-normal	PS-injured	PS-normal	AS-injured	AS-normal
1	M	6	2	-10	70	-50	70	90	90	90	90
2	F	6	2	0	70	-10	45	90	90	45	90
3	F	10	2	0	80	-20	70	90	90	90	90
4	F	7	2	20	90	10	90	90	90	60	90
5	M	11	1	20	35	15	35	90	90	45	90
6	F	11	1	10	80	0	80	80	80	40	80
7	M	7	1	-10	60	-30	60	90	90	90	90
8	M	10	2	30	80	-70	80	90	90	90	90
9	M	6	2	85	85	50	85	90	90	80	90
10	F	4	2	90	90	30	90	70	90	0	90
11	M	9	1	90	90	60	90	90	90	50	90
12	M	8	1	90	90	70	90	90	90	60	90
13	F	8	1	70	90	60	85	50	90	60	90
14	F	12	1	90	90	80	90	90	90	80	90
15	F	14	1	80	90	70	90	80	90	70	90
16	M	6	2	80	95	70	90	90	90	85	90
17	M	9	2	90	90	10	80	10	90	10	80
18	M	6	1	60	90	40	90	70	90	30	85
19	M	8	2	80	90	70	90	80	90	70	90
20	M	9	2	90	90	70	90	90	90	70	80
21	M	9	2	90	90	90	90	90	90	70	90
22	M	5	1	80	90	60	90	90	90	90	90
23	F	10	2	45	90	30	90	90	90	80	90
24	F	8	2	80	90	70	90	90	90	80	90
25	F	10	2	0	80	-70	80	90	90	90	90
26	F	6	2	70	80	60	70	80	90	40	90
27	F	5	2	50	80	30	75	40	80	20	70
28	M	6	2	70	80	60	70	80	90	40	90
29	M	4	2	60	90	40	85	85	90	45	90
30	F	7	1	50	90	40	80	60	90	30	90
31	M	4	2	50	90	30	90	80	90	40	90
32	F	7	1	80	90	60	80	80	90	70	80

	Mean	Median	Standard deviation	VC	Min	Max	N	CI	p-Value
PP
Injured	55.6	70	34.4	62%	-10	90	32	11.9	<0.001
Normal	83.9	90	11.8	14%	35	95	32	4.1

PA
Injured	32	40	43.1	135%	-70	90	32	14.9	<0.001
Normal	80.6	85	13.5	17%	35	90	32	4.7

SP
Injured	80.2	90	17.8	22%	10	90	32	6.2	0.005
Normal	89.4	90	2.5	3%	80	90	32	0.9

SA
Injured	59.7	65	25.4	43%	0	90	32	8.8	<0.001
Normal	88	90	4.7	5%	70	90	32	1.6

Age	Mean	Median	Standard deviation	VC	Min	Max	N	CI	p-Value
PP
From 4 to 6 years	57.1	65	31.8	56%	-10	90	12	18	0.092
From 7 to 9 years	68.3	80	32.4	47%	-10	90	12	18.3
More than 10 years	34.4	25	34.8	101%	0	90	8	24.1

PA
From 4 to 6 years	34.2	40	34	99%	-50	70	12	19.2	0.077
From 7 to 9 years	48.3	60	34.6	72%	-30	90	12	19.6
More than 10 years	4.4	7.5	56.7	1295%	-70	80	8	39.3

SP
From 4 to 6 years	79.6	82.5	14.5	18%	40	90	12	8.2	0.365
From 7 to 9 years	75.8	90	24.7	33%	10	90	12	14
More than 10 years	87.5	90	4.6	5%	80	90	8	3.2

SA
From 4 to 6 years	50.4	42.5	29.3	58%	0	90	12	16.6	0.147
From 7 to 9 years	60	65	21.7	36%	10	90	12	12.3
More than 10 years	73.1	80	20.2	28%	40	90	8	14

Type of lesion	Mean	Median	Standard deviation	VC	Min	Max	N	CI	p-Value
PP
Partial	59.2	75	34.5	58%	-10	90	12	19.5	0.66
Total	53.5	65	35.1	66%	-10	90	20	15.4

AP
Partial	43.8	60	33	75%	-30	80	12	18.7	0.24
Total	25	30	47.6	191%	-70	90	20	20.9

PS
Partial	80	85	13.5	17%	50	90	12	7.6	0.97
Total	80.3	90	20.3	25%	10	90	20	8.9

AS
Partial	59.6	60	21.2	36%	30	90	12	12	0.986
Total	59.8	70	28.2	47%	0	90	20	12.3

Sociedade Brasileira de Ortopedia e Traumatologia Al. Lorena, 427 14º andar, 01424-000 São Paulo - SP - Brasil, Tel.: 55 11 2137-5400 - São Paulo - SP - Brazil
E-mail: rbo@sbot.org.br

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[1] ^*Corresponding author.E-mail: dr.yussefali@gmail.com (Y.A. Abdouni).

	Gender	Age	Type of lesion	PP-injured	PP-normal	AP-injured	AP-normal	PS-injured	PS-normal	AS-injured	AS-normal
1	M	6	2	-10	70	-50	70	90	90	90	90
2	F	6	2	0	70	-10	45	90	90	45	90
3	F	10	2	0	80	-20	70	90	90	90	90
4	F	7	2	20	90	10	90	90	90	60	90
5	M	11	1	20	35	15	35	90	90	45	90
6	F	11	1	10	80	0	80	80	80	40	80
7	M	7	1	-10	60	-30	60	90	90	90	90
8	M	10	2	30	80	-70	80	90	90	90	90
9	M	6	2	85	85	50	85	90	90	80	90
10	F	4	2	90	90	30	90	70	90	0	90
11	M	9	1	90	90	60	90	90	90	50	90
12	M	8	1	90	90	70	90	90	90	60	90
13	F	8	1	70	90	60	85	50	90	60	90
14	F	12	1	90	90	80	90	90	90	80	90
15	F	14	1	80	90	70	90	80	90	70	90
16	M	6	2	80	95	70	90	90	90	85	90
17	M	9	2	90	90	10	80	10	90	10	80
18	M	6	1	60	90	40	90	70	90	30	85
19	M	8	2	80	90	70	90	80	90	70	90
20	M	9	2	90	90	70	90	90	90	70	80
21	M	9	2	90	90	90	90	90	90	70	90
22	M	5	1	80	90	60	90	90	90	90	90
23	F	10	2	45	90	30	90	90	90	80	90
24	F	8	2	80	90	70	90	90	90	80	90
25	F	10	2	0	80	-70	80	90	90	90	90
26	F	6	2	70	80	60	70	80	90	40	90
27	F	5	2	50	80	30	75	40	80	20	70
28	M	6	2	70	80	60	70	80	90	40	90
29	M	4	2	60	90	40	85	85	90	45	90
30	F	7	1	50	90	40	80	60	90	30	90
31	M	4	2	50	90	30	90	80	90	40	90
32	F	7	1	80	90	60	80	80	90	70	80

	Gender	Age	Type of lesion	PP-injured	PP-normal	AP-injured	AP-normal	PS-injured	PS-normal	AS-injured	AS-normal
1	M	6	2	-10	70	-50	70	90	90	90	90
2	F	6	2	0	70	-10	45	90	90	45	90
3	F	10	2	0	80	-20	70	90	90	90	90
4	F	7	2	20	90	10	90	90	90	60	90
5	M	11	1	20	35	15	35	90	90	45	90
6	F	11	1	10	80	0	80	80	80	40	80
7	M	7	1	-10	60	-30	60	90	90	90	90
8	M	10	2	30	80	-70	80	90	90	90	90
9	M	6	2	85	85	50	85	90	90	80	90
10	F	4	2	90	90	30	90	70	90	0	90
11	M	9	1	90	90	60	90	90	90	50	90
12	M	8	1	90	90	70	90	90	90	60	90
13	F	8	1	70	90	60	85	50	90	60	90
14	F	12	1	90	90	80	90	90	90	80	90
15	F	14	1	80	90	70	90	80	90	70	90
16	M	6	2	80	95	70	90	90	90	85	90
17	M	9	2	90	90	10	80	10	90	10	80
18	M	6	1	60	90	40	90	70	90	30	85
19	M	8	2	80	90	70	90	80	90	70	90
20	M	9	2	90	90	70	90	90	90	70	80
21	M	9	2	90	90	90	90	90	90	70	90
22	M	5	1	80	90	60	90	90	90	90	90
23	F	10	2	45	90	30	90	90	90	80	90
24	F	8	2	80	90	70	90	90	90	80	90
25	F	10	2	0	80	-70	80	90	90	90	90
26	F	6	2	70	80	60	70	80	90	40	90
27	F	5	2	50	80	30	75	40	80	20	70
28	M	6	2	70	80	60	70	80	90	40	90
29	M	4	2	60	90	40	85	85	90	45	90
30	F	7	1	50	90	40	80	60	90	30	90
31	M	4	2	50	90	30	90	80	90	40	90
32	F	7	1	80	90	60	80	80	90	70	80

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Relationship of age and type of obstetric brachial plexus paralysis in forearm pronosupination ☆ ☆ Paper developed at Hospital da Irmandade da Santa Casa de São Paulo, Departamento de Ortopedia e Traumatologia, São Paulo, SP, Brazil.

ABSTRACT

Objective:

Methods:

Results:

Conclusion:

Relationship of age and type of obstetric brachial plexus paralysis in forearm pronosupination ^☆ ☆ Paper developed at Hospital da Irmandade da Santa Casa de São Paulo, Departamento de Ortopedia e Traumatologia, São Paulo, SP, Brazil.

	Gender	Age	Type of lesion	PP-injured	PP-normal	AP-injured	AP-normal	PS-injured	PS-normal	AS-injured	AS-normal
1	M	6	2	-10	70	-50	70	90	90	90	90
2	F	6	2	0	70	-10	45	90	90	45	90
3	F	10	2	0	80	-20	70	90	90	90	90
4	F	7	2	20	90	10	90	90	90	60	90
5	M	11	1	20	35	15	35	90	90	45	90
6	F	11	1	10	80	0	80	80	80	40	80
7	M	7	1	-10	60	-30	60	90	90	90	90
8	M	10	2	30	80	-70	80	90	90	90	90
9	M	6	2	85	85	50	85	90	90	80	90
10	F	4	2	90	90	30	90	70	90	0	90
11	M	9	1	90	90	60	90	90	90	50	90
12	M	8	1	90	90	70	90	90	90	60	90
13	F	8	1	70	90	60	85	50	90	60	90
14	F	12	1	90	90	80	90	90	90	80	90
15	F	14	1	80	90	70	90	80	90	70	90
16	M	6	2	80	95	70	90	90	90	85	90
17	M	9	2	90	90	10	80	10	90	10	80
18	M	6	1	60	90	40	90	70	90	30	85
19	M	8	2	80	90	70	90	80	90	70	90
20	M	9	2	90	90	70	90	90	90	70	80
21	M	9	2	90	90	90	90	90	90	70	90
22	M	5	1	80	90	60	90	90	90	90	90
23	F	10	2	45	90	30	90	90	90	80	90
24	F	8	2	80	90	70	90	90	90	80	90
25	F	10	2	0	80	-70	80	90	90	90	90
26	F	6	2	70	80	60	70	80	90	40	90
27	F	5	2	50	80	30	75	40	80	20	70
28	M	6	2	70	80	60	70	80	90	40	90
29	M	4	2	60	90	40	85	85	90	45	90
30	F	7	1	50	90	40	80	60	90	30	90
31	M	4	2	50	90	30	90	80	90	40	90
32	F	7	1	80	90	60	80	80	90	70	80