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Novedosa transferencia tendinosa de redondo mayor en parálisis braquial obstétrica y comparativa con técnica gold standard
Novel Teres Major Tendon Transfer in Obstetric Brachial Palsy and Comparison with the Gold Standard Technique
GUTIÉRREZ-PEREIRA J, BATALLER-ALBORCH JL, PAULOS-DOS SANTOS F, GARCÍA-LÓPEZ A.
SERVICIO DE CIRUGÍA ORTOPÉDICA. HOSPITAL GENERAL UNIVERSITARIO DOCTOR BALMIS DE ALICANTE.
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Introduction: Brachial Plexus Birth Injury generally affects the upper roots of the brachial plexus and can cause an imbalance of rotatory forces acting on the glenohumeral joint that leads to progressive dysplasia of the joint with functional repercussions on the upper limb. Methods: The results of the teres major transfer with section of the coracohumeral ligament are retrospectively compared with the functional results of the latissimus dorsi transfer. All patients underwent surgery at our center from January 2012 to December 2022. Functional assessment was performed with the range of motion (ROM) and the Mallet scale. Results: A total of 40 patients underwent surgery, 20 underwent teres major transfer and 20 underwent latissimus dorsi transfer. In both cohorts, section of the coracohumeral ligament was also performed. The mean age of the total cohort was 3.9 years (range 2.7 - 4.8). In the cohort that underwent teres major transfer, the mean gain in active abduction, active external rotation, and passive external rotation was +77º, +44º, and +46º; In the cohort that underwent latissimus dorsi transfer, the gain was +46º, +27º, +24º, respectively. Conclusion: Transfer of the teres major tendon to the supraspinatus tendon together with transection of the coracohumeral ligament significantly improves shoulder abduction and external rotation in patients with obstetric brachial palsy with internal rotation contracture and appears to be a better therapeutic option than tendon transfer. from latissimus dorsi to supraspinatus by offering better functional results.
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