Extended Long-Term (5 Years) Outcomes of Triangle Tilt Surgery in Obstetric Brachial Plexus Injury

Abstract

OBJECTIVE: We evaluated the "extended" long-term (5 years) functional outcomes in obstetric brachial plexus injury (OBPI) patients, who underwent triangle tilt surgery between February 2005 and January 2008. METHODS: Twenty two children (9 girls and 13 boys, mean age at surgery was 5.8 years; ranging 2.1-11.8 years old), who initially presented with medial rotation contracture and scapula deformity secondary to obstetric brachial plexus injury were included in this study. Functional movements were evaluated pre-operatively, and 5 years following triangle tilt surgery by modified Mallet scale. RESULTS: Here, we report long-term (5 years) follow-up of triangle tilt surgery for 22 OBPI patients. Upper extremity functional movements such as, external rotation (2.5+/-0.6 to 4.1+/-0.8, p<0.0001), hand-to-spine (2.6+/-0.6 to 3.4+/-1.1, p<0.005), hand-to-neck (2.7+/-0.7 to 4.3+/-0.7, p<0.0001), hand-to-mouth (2.3+/-0.9 (92 masculine+/-33) to 4.2+/-0.5 (21 masculine+/-16), p<0.0001), and supination (2.6+/-1.1 (-8.2 masculine +/-51) to 4.1+/-0.7 (61+/-32)) were significantly improved (p<0.0001), and maintained over the extended long-term (5 years). Total modified Mallet functional score was also shown to improve from 14.1+/-2.7 to 20.3+/-2.5. CONCLUSIONS: The triangle tilt surgery improved all shoulder functions significantly, and maintained over the extended long-term (5 years) in these patients.