DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20164628

Results of Sever- L’ Episcopo procedure for obstetric brachial plexus palsy

Karthi Sundar V., Anil Kumar S.V.

Abstract


Background: The reported incidence of obstetric brachial plexus palsy (OBPP) varies from 0.3 to 2.5 per 1000 live birthsresulting in internal rotation deformity and weak abduction of the involved side shoulder.

Methods: To retrospectively analyse the functional results of the Sever- L‘ Episcopo procedure for OBPP with a minimum follow-up of 2 years to a maximum of 13 years using modified Mallet scoring system for shoulder.

Results: A significant improvement in the range of abduction and the restoration of external rotation of shoulder was achieved with Sever- L’Episcopo procedure.

Conclusions: The results of secondary reconstruction of a dysfunctional shoulder by means of a Lattismus dorsi & Teres major transfer as described by Sever- L’Episcopo is definitely beneficial. However this procedure will improve, but will not normalize, function. Apart from functional improvement this procedure corrects a deformity thereby easing the psycho-social stigma associated with it.


Keywords


Sever- L’Episcopo procedure, Obstetric brachial plexus palsy

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References


Smellie W. A Collection of Cases and Observations in Midwifery (Volume 2). London: D Wilson; 1754; 446-448.

Erb W. Ueber eine eigenthümliche localisation von Lähmun gen implexus brachialis. Verhandlungen des naturhisorischen vereins von Heidelberg. 1874;2;130-7.

Birch R. Obstetric brachial plexus palsy. J Hand Surg. 2002;27:3-8.

Waters PM, Bae DS. Effect of tendon transfers and intra articular soft tissue balancing on glenohumeral development in brachial plexus birth palsy. J Am Academy Orthop Surg. 1997;5:205-14.

L’ Episcopo J. Tendon transplant in obstetrical paralysis. Am J Surg. 1934;25:122.

L’ Episcopo J. Restoration of muscle balance in treatment of obstetric paralysis; New York State. J Med. 1939;39:357.

Strecter WB, McAllister JW, Schoenecker PL, Dailey LA, Sever-L’Episcopo transfers in obstetrical palsy: a retrospective review of twenty cases. J Paed Orthop. 1990;19:442-4.

Covey DC, Riordan DC, Milstead ME, Albright AJ. Modification of L’ Episcopo procedure for brachial plexus birth palsies. J Bone Joint Surg (British vol). 1992;74:897-901.

Kirkos JM, Kyrkos MJ, Kapetanous GA, Haritidis JH. Long term results of anterior release and tendon transfers around shoulder. J Bone Joint Surg Br. 2005;87:231-5.