Article ; Online: Prevalence and predictors of elbow flexion contractures during early childhood following brachial plexus birth injury.
Journal of hand therapy : official journal of the American Society of Hand Therapists
2024
Abstract: Background: Elbow flexion contracture development in school-age children with a brachial plexus birth injury (BPBI) is common. Reports indicate onset between 2 and 4 years; however, little is known about early childhood prevalence, development, and ... ...
| Abstract | Background: Elbow flexion contracture development in school-age children with a brachial plexus birth injury (BPBI) is common. Reports indicate onset between 2 and 4 years; however, little is known about early childhood prevalence, development, and trajectory of these contractures. Purpose: To determine the prevalence and predictors of BPBI elbow flexion contractures during early childhood. Study design: A retrospective cross-sectional study. Methods: Demographic, diagnostic, treatment, and elbow contracture data were collected for children with a BPBI <4 years between 2015 and 2019 from a prospectively collected database. Spinal root motor contributions and injury were determined using Active Movement Scale (AMS) scores at 6 weeks of age and used to predict contracture development. Results: Of the 171 children that met inclusion criteria, 87% (n = 149) had upper plexus injuries. The mean age at the time of evaluation for an elbow contracture was 21.4 ± 12.7 months. The prevalence of elbow flexion contractures was 22% (n = 38), with mean onset at 13.4 ± 11.0 months. Mean contracture degree was -10.8 ± -6.9 degrees with 76% (n = 29) <-10 degrees. AMS shoulder abduction, flexion, and external rotation; elbow flexion; forearm supination; and wrist extension scores at a mean 2.3 ± 1.4 months were significantly lower in children who developed elbow flexion contractures (p < 0.001). Logistic regression found that low AMS elbow flexion with high elbow extension scores were a significant (p < 0.003) predictor of elbow contracture development. Conclusions: The prevalence of elbow flexion contractures in early childhood is greater than previously understood. These findings indicate that C5-C6 injury affecting elbow flexion with relative preservation of elbow extension is a predictor of contracture development. Further research is needed to investigate the nature and sequelae of C5-C6 injury and its effects on elbow flexion contracture development. |
|---|---|
| Language | English |
| Publishing date | 2024-02-10 |
| Publishing country | United States |
| Document type | Journal Article |
| ZDB-ID | 639284-2 |
| ISSN | 1545-004X ; 0894-1130 |
| ISSN (online) | 1545-004X |
| ISSN | 0894-1130 |
| DOI | 10.1016/j.jht.2023.09.003 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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