Magnetic resonance imaging glenohumeral joint analysis before and after muscle transfer in children with obstetric brachial plexus palsy: a cross-sectional study of 10 cases.

Abstract

This study aims to analyze the impact of muscle transfer on the glenohumeral joint in children with obstetric brachial plexus palsy (OBPP) using MRI by comparing preoperative and 5-year follow-up postoperative imaging findings to determine whether tendon transfers affect the alignment and configuration of the glenohumeral joint. Ten children with obstetric brachial plexus palsy (OBPP) participated in our prospective observational study, and we performed a tendon transfer technique. Every patient had an MRI of both shoulders done at preoperative and at the 5-year mark following the procedure. The glenoid form, glenoid version, humeral head hypoplasia (HHH), and percentage of the humeral head anterior (PHHA) were the parameters that were evaluated. The glenoscapular angle (GSA) was used to evaluate the glenoid version. Following tendon transfer surgery, MRI data show a regression of humeral head hypoplasia, and a statistically significant difference (p=0.0057) was observed between preoperative and postoperative results. Three individuals additionally recovered a normal glenoid shape. None of the remaining patients had a type 3 form; all had a type 2 form. Additionally, compared to the postoperative side, the damaged preoperative side's GSA was much more retroverted (p < 0.05). The mean PHHA for the afflicted shoulder was 25.8%, ranging from 0% to 40%, compared with 40.5% for the postoperative affected shoulder, indicating an improvement in humeral head subluxation (PHHA). As a result, the two results did not differ statistically. While tendon transfers led to only minor improvements in humeral head subluxation, they greatly improved glenoid retroversion and humeral head hypoplasia. It has been established that MRI is a useful diagnostic technique for glenohumeral anomalies due resulting from obstetric brachial plexus palsy.