Background

Brachial plexus birth palsy remains a frequent condition and one of its treatments is to transfer the Latissimus Dorsi tendon to the infraspinatus muscle. The aim of this study was to analyse, for the first time, the three-dimensional kinematic effects of this operation on the upper limb joints during the five Mallet tasks and their correlation with clinical parameters.

Methods

Kinematic analysis was performed using an electromagnetic device. An Index of Improvement taking into account the angle in preop and postop, the reproducibility and the angle of a control group was developed. Three groups of patients were analysed: sixteen patients (mean: 10,5 years) for the reproducibility, thirty children (mean: 9,5 years) for the control group and ten patients (mean: 8 years 7 months) who were operated.

Findings

The humerothoracic and glenohumeral external rotations improved during the external rotation, the neck and the abduction tasks and worsened during the spine task. The glenohumeral external rotation worsened during the mouth task. The Humerothoracic abduction improved during the abduction and the neck tasks. The elbow flexion improved for the neck task. Differences were observed between patients and correlations were obtained between the Index of Improvement and clinical parameters.

Interpretation

Using kinematics allows to better analyse the evolution of joint angles after the latissimus dorsi transfer. The Index of Improvement allows to quickly analyse the effect of the operation for each angle and each patient. This effect depends on clinical parameters.

中文翻译：

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臂丛神经出生性麻痹患儿背阔肌移植术后上肢运动学

背景

臂丛神经出生麻痹仍然是一种常见疾病，其治疗方法之一是将背阔肌肌腱转移到冈下肌。本研究的目的是首次分析该操作在五项 Mallet 任务中对上肢关节的三维运动学影响及其与临床参数的相关性。

方法

使用电磁装置进行运动学分析。考虑到术前和术后的角度、再现性和对照组的角度，制定了改进指数。分析了三组患者：16 名患者（平均：10.5 岁）的可重复性，30 名儿童（平均：9.5 岁）作为对照组和 10 名患者（平均：8 岁 7 个月）进行手术。

发现

肱胸外旋和盂肱外旋在外旋、颈部和外展任务中得到改善，在脊柱任务中恶化。在口腔任务期间盂肱外旋恶化。在外展和颈部任务期间，肱胸外展得到改善。肘部屈曲改善了颈部任务。在患者之间观察到差异并且在改善指数和临床参数之间获得相关性。

解释

使用运动学可以更好地分析背阔肌转移后关节角度的演变。改善指数允许快速分析每个角度和每个患者的手术效果。这种效果取决于临床参数。