What influences contracture formation in lower motor neuron disorders, severity of denervation or residual muscle function? An analysis of the elbow contracture in 100 children with unilateral brachial plexus birth injury
| العنوان: | What influences contracture formation in lower motor neuron disorders, severity of denervation or residual muscle function? An analysis of the elbow contracture in 100 children with unilateral brachial plexus birth injury |
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| المؤلفون: | W. J. R. van Ouwerkerk, J. A. van der Sluijs, M. J. van der Sluijs, F. van de Bunt |
| المساهمون: | Orthopedic Surgery and Sports Medicine, Amsterdam Movement Sciences - Restoration and Development, VU University medical center, Neurosurgery |
| المصدر: | van der Sluijs, J A, van der Sluijs, M J, van de Bunt, F & van Ouwerkerk, W J R 2018, ' What influences contracture formation in lower motor neuron disorders, severity of denervation or residual muscle function? An analysis of the elbow contracture in 100 children with unilateral brachial plexus birth injury ', Journal of Children's Orthopaedics, vol. 12, no. 5, pp. 544-549 . https://doi.org/10.1302/1863-2548.12.180051 Journal of Children's Orthopaedics, 12(5), 544-549. Springer Verlag Journal of Children's Orthopaedics |
| سنة النشر: | 2018 |
| مصطلحات موضوعية: | brachial plexus birth injury, Elbow, obstetric brachial plexus lesion, Lower motor neuron, 03 medical and health sciences, 0302 clinical medicine, Original Clinical Article, Medicine, Orthopedics and Sports Medicine, Muscle contracture, Denervation, Flexion contracture, 030222 orthopedics, denervation, business.industry, muscle paresis, medicine.disease, Birth injury, flexion contracture, medicine.anatomical_structure, Anesthesia, Pediatrics, Perinatology and Child Health, Contracture, medicine.symptom, business, Brachial plexus, 030217 neurology & neurosurgery |
| الوصف: | Purpose As in other neuromuscular disorders, both denervation and muscle paresis/imbalance are implicated as aetiological factors for contractures in children with a Brachial Plexus Birth Injury (BPBI). Although both factors are related, it is unclear which factor is dominant. The aim of this study is to assess whether contracture formation in children is predominantly related to denervation or to residual muscle function/imbalance. This might be relevant for understanding contracture formation in other neuromuscular disorders. Methods A total of 100 children (61 boys; mean age 10.4 years, 4 to 18) with unilateral BPBI were included in this cross-sectional study. Severity of the denervation was classified according to Narakas. Muscle function of flexors and extensors of both elbows was measured (in Newtons) using a hand-held dynamometer and flexion contractures were measured with a goniometer. The relation between denervation, muscle function/muscle balance and flexion contracture was assessed using univariate and multivariate analysis. Results Of the children, 57 were Narakas class I, 13 class II and 30 class III. Mean flexion contracture was 25° (90° to −5°). At the affected side the forearm flexion force was 47% and extension force was 67% of the force of the unaffected side. Contractures were more severe in children with higher Narakas classifications (p = 0.001), after neurosurgery (Mann-Whitney U test, p = 0.009) and were related to age (Spearman's Rho = −0.3, p = 0.008) and to paresis of the extensors (Rho = 0.4, p = 0.000). Flexor paresis as a percentage of unaffected side (Rho = 0.06, p = 0.6) and muscle balance had no influence. Conclusion In BPBI, elbow contractures are related to the severity of the neurological lesion, not to residual muscle function. Level of evidence Level II – prognostic study |
| اللغة: | English |
| تدمد: | 1863-2521 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::9f45f0f4846419b18ff1d962aa461c0f https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85063466200&origin=inward |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....9f45f0f4846419b18ff1d962aa461c0f |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 18632521 |
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