Influence of Brachial Plexus Birth Injury Location on Glenohumeral Joint Morphology

Overview

Journal J Hand Surg Am

Publisher Elsevier

Date 2020 Dec 28

PMID 33358583

Citations 2

Authors

Nikhil N Dixit

Carolyn M McCormick

Jacqueline H Cole

Katherine R Saul

Affiliations

Soon will be listed here.

Abstract

Purpose: Patient presentation after brachial plexus birth injury (BPBI) is influenced by nerve injury location; more contracture and bone deformity occur at the shoulder in postganglionic injuries. Although bone deformity after postganglionic injury is well-characterized, the extent of glenohumeral deformity after preganglionic BPBI is unclear.

Methods: Twenty Sprague-Dawley rat pups received preganglionic or postganglionic neurectomy on a single forelimb at postnatal days 3 to 4. Glenohumeral joints on affected and unaffected sides were analyzed using micro-computed tomography scans after death at 8 weeks after birth. Glenoid version, glenoid inclination, glenoid and humeral head radius of curvature, and humeral head thickness and width were measured bilaterally.

Results: The glenoid was significantly more declined in affected compared with unaffected shoulders after postganglionic (-17.7° ± 16.9°) but not preganglionic injury. Compared with the preganglionic group, the affected shoulder in the postganglionic group exhibited significantly greater declination and increased glenoid radius of curvature. In contrast, the humeral head was only affected after preganglionic but not postganglionic injury, with a significantly smaller humeral head radius of curvature (-0.2 ± 0.2 mm), thickness (-0.2 ± 0.3 mm), and width (-0.3 ± 0.4 mm) on the affected side compared with the unaffected side; changes in these metrics were significantly associated with each other.

Conclusions: These findings suggest that glenoid deformities occur after postganglionic BPBI but not after preganglionic BPBI, whereas the humeral head is smaller after preganglionic injury, possibly suggesting an overall decreased biological growth rate in this group.

Clinical Relevance: This study expands understanding of the altered glenoid and humeral head morphologies after preganglionic BPBI and its comparisons with morphologies after postganglionic BPBI.

Citing Articles

Individuals with rotator cuff tears unsuccessfully treated with exercise therapy have less inferiorly oriented net muscle forces during scapular plane abduction.

Mattar L, Mahboobin A, Popchak A, Anderst W, Musahl V, Irrgang J J Biomech. 2023; 162:111859.

PMID: 37989027 PMC: 10843663. DOI: 10.1016/j.jbiomech.2023.111859.

Integrated iterative musculoskeletal modeling predicts bone morphology following brachial plexus birth injury (BPBI).

Dixit N, McFarland D, Fisher M, Cole J, Saul K J Biomech. 2020; 103:109658.

PMID: 32089271 PMC: 7141945. DOI: 10.1016/j.jbiomech.2020.109658.

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