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Development of the glenohumeral joint after subscapular release and open relocation in children with brachial plexus birth palsy: Long-term results in 61 patients

Journal of Shoulder and Elbow Surgery May 19, 2019

Jönsson K, et al. - In patients with an internal rotation contracture and joint incongruity due to brachial plexus birth palsy, authors determined the long-term outcomes of remodeling of the glenohumeral joint following open subscapularis elongation and relocation of the humeral head via a before-and-after study. This study included an aggregate of 61 patients going through open subscapularis elongation and reduction of the glenohumeral joint was assessed regarding joint remodeling. Consistent remodeling of incongruent shoulders was obtained via open subscapularis lengthening with joint repositioning, up to the age of 5 years, with minimal difference between the operated and unaffected shoulders at long-term follow-up. In the adolescent age group, open reduction was found to be useful. The notion that older children should be treated with derotational humeral osteotomy was also challenged.
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