Purpose
Elbow flexion contractures are a common sequela in obstetric brachial plexus palsy.
The etiology and best management of these contractures is unclear. Nonsurgical treatment
involving serial casting and splinting is supported in the literature. The purpose
of this study is to evaluate the effectiveness of serial casting and splinting of
elbow flexion contractures in children with obstetric brachial plexus palsy.
Methods
A retrospective review of children with obstetric brachial plexus palsy who participated
in serial casting and splinting for an elbow flexion contracture was conducted. Elbow
extension passive range of motion measurements at initial, best-achieved, and final
outcome were compared.
Results
Nineteen patients, aged 2 to 16 years, were studied. Elbow passive range of motion
improved from initial to best-achieved and final outcome measurements. Fifty-three
percent of patients were noncompliant between the time of best-achieved and final
outcome. Loss of passive range of motion during the noncompliant period was statistically
significant. Compliant patients had better treatment results. A clinical decision
tree for elbow contractures in obstetric brachial plexus palsy was formulated.
Conclusions
Serial casting and splinting of elbow contractures in children with obstetric brachial
plexus palsy is effective. Successful maintenance of treatment effects is dependent
on patient age and compliance.
Type of study/level of evidence
Therapeutic IV.
Key words
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Article info
Publication history
Published online: December 04, 2009
Accepted:
September 17,
2009
Received:
May 19,
2009
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2010 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
