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Oberlin’s procedure in children with obstetric brachial plexus palsy

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Abstract

Purpose

Most cases of obstetric brachial plexus palsy (OBPP) involve C5 and C6 nerve roots (Erb’s palsy). In those cases, re-establishing the elbow flexion is the primary goal of surgery. The partial transfer of the ulnar nerve to the musculocutaneous nerve (Oberlin’s procedure) is widely used in adults, but incipient in children. The purpose of this study is to describe the results obtained with such procedure as regards the improvement of the elbow flexion and donor nerve morbidity.

Method

Thirteen children aged 9 to 15 months underwent Oberlin’s procedure. They were assessed preoperatively and 1 year postoperatively using the active movement scale and also according to the functionality of the affected limb. All of them were evaluated because of the possibility of movement loss resulting from the donor nerve. We used the non-parametric, statistic Wilcoxon signed rank test (α = 0,05) method.

Results

There was a significant improvement in the active elbow flexion between pre- and postoperative periods. Eleven children presented functional improvement. All of them maintained negative cookie test 1 year after the surgery. We did not observe any loss related to the donor nerve in terms of wrist flexion.

Conclusion

The results suggest that Oberlin’s procedure can be an effective and safe alternative to treat elbow flexion in Erb’s palsy.

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Acknowledgments

The authors thank Luiz Guilherme Nadal Nunes for the statistical analysis.

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Authors and Affiliations

  1. Sarah Network of Hospitals, SMHS Q. 501 Conj. A, Brasilia, DF, 70335-901, Brazil

    Roberta de Matos Figueiredo, Giuliana Grechi & Ricardo de Amoreira Gepp

Authors
  1. Roberta de Matos Figueiredo
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  2. Giuliana Grechi
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  3. Ricardo de Amoreira Gepp
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Corresponding authors

Correspondence to Roberta de Matos Figueiredo or Giuliana Grechi.

Ethics declarations

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committees and with the 1964 Helsinki Declaration and its later amendments, or comparable ethical standards.

Informed consent

Formal consent is not required from all participants in this type of study. Consent was only sought from the participants for whom identifying information was included in this article.

Conflict of interest

The authors declare that they have no conflict of interest.

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Figueiredo, R.d.M., Grechi, G. & Gepp, R.d.A. Oberlin’s procedure in children with obstetric brachial plexus palsy. Childs Nerv Syst 32, 1085–1091 (2016). https://doi.org/10.1007/s00381-015-3007-9

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  • DOI: https://doi.org/10.1007/s00381-015-3007-9

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