Outcome in adolescence of brachial plexus birth palsy

Figures & data

Table 1. Background information on study participants (n = 69)

	n
Gender
Boys	36
Girls	33
Lesion side
Right	40
Left	29
Fracture at birth
Clavicle	27
Humerus	4
Regained biceps function
< 1 month	38
1–3 month	15
> 3 months	16
Surgery
Primary surgery	1
Secondary surgery	3

Table 2. Modified Mallet classification subscores and total scores (median with range) in participants with transient and permanent lesion after brachial plexus birth palsy

	Transient	Permanent
	(n = 52)	Surgery (n = 4)	No surgery (n = 13)
Shoulder movement
Abduction	5 (4–5)	3.5 (3–5)	4 (3–5)
External rotation	5 (5–5)	2 (1–3)	3 (2–3)
Hand to neck	5 (5–5)	2 (2–3)	3 (3–4)
Hand to back	5 (4–5)	2 (2–3)	3 (2–4)
Hand to mouth	5 (5–5)	2 (1–3) ^a	3 (2–4) ^b
Total Mallet score	25 (23–25)	12.5 (9–15)	16 (13–19)

^a 2 participants had marked trumpet sign (Mallet 2), 1 had partial trumpet sign (Mallet 3).

^b 2 participants had marked trumpet sign (Mallet 2), 10 had partial trumpet sign (Mallet 3).

Table 3. Active range of motion in affected shoulder and arm (median with range) in participants with transient and permanent lesion

	Transient	Permanent
	(n = 52)	Surgery (n = 4)	No surgery (n = 13)	p-value ^a
Shoulder
Flexion	160° (135–180)	115° (30–140)	135° (90–155)	0.001
Abduction	175° (160–180)	110° (40–175)	155° (90–175)	0.001
External rotation	60° (30–90)	–20° (–20 to 15) ^b	0° (–35 to 15)	0.001
Internal rotation	90° (90–90)	85° (30–90)	90° (70–90)	0.004
Elbow
Flexion	150° (140–155)	143° (130–150)	140° (135–150)	0.01
Extension	185° (165–205)	165° (120–175)	160° (140–180)	0.001
Forearm
Pronation	85° (70–90)	60° (–10 to 90)	90° (60–90)	1
Supination	90° (65–90)	50° (–20 to 80)	70° (–10 to 90)	0.000
Wrist
Flexion	85° (70–95)	60° (35–80) ^b	80° (65–90)	0.1
Extension	80° (45–90)	60° (50–70) ^b	70° (30–75)	0.003

^a Differences between participants with transient lesion and participants with permanent lesion and no surgery (Mann-Whitney U-test).

^b n = 3, the participant with primary surgery had no active motion.

Table 4. Individual difference in passive range of motion (median with range) between affected and unaffected shoulder in participants with transient and permanent lesion

PROM difference	Transient	Permanent
	(n = 52)	Surgery (n = 4)	No surgery (n = 13)	p-value ^a
Shoulder
External rotation	2.5° (–15 to 20)	43° (20–55)	50° (–10 to 70)	0.001
Glenohumeral abduction	0° (–15 to 15)	15° (10–70)	15° (–5 to 25)	0.001

^a Differences between participants with transient lesion and participants with permanent lesion and no surgery (Mann-Whitney U-test).

Table 5. Strength differences (median with range) between affected and unaffected shoulder and hand, for each participant with a transient or permanent lesion. The difference is presented in percentage of the unaffected arm with negative difference if the affected arm was the strongest

Strength difference	Transient	Permanent
	(n = 52)	Surgery (n = 4)	No surgery (n = 13)	p-value ^a
Shoulder
External rotation	2% (–54 to 52)	73% (30–82) ^b	45% (6–66) ^c	0.001
Internal rotation	–2% (–50 to 60)	39% (31–42) ^b	17% (–16 to 42) ^c	0.003
Hand
Grip strength	–1% (–37 to 44)	15% (4–100)	11% (–8 to 27)	0.003

^a Differences between participants with transient lesion and participants with permanent lesion and no surgery (Mann-Withney U-test).

^b n = 3, the participant with primary surgery was not tested.

^c n = 12, 1 participant refused to be tested.

Frequency distribution of the modified Mallet classification total score of the 69 participants at follow-up.