Alluri RK, Lightdale-Miric N, Meisel E, et al. - In order to find out the mid-term functional outcomes of a large series of individuals who underwent the Hoffer procedure for brachial plexus birth palsy (BPBP), researchers retrospectively examined all individuals who underwent the Hoffer procedure with minimum two-year follow-up. They applied the active shoulder range of movement (ROM), aggregate modified Mallet classification scores, Hospital for Sick Children Active Movement Scale (AMS) scores, and/or Toronto Test Scores to evaluate functional outcomes. In the study, a sum of 107 individuals, average age 3.9 years (1.6 to 13) and 59% female, were recruited with mean 68 months (24 to 194) follow-up. At mid-term follow-up, individuals with BPBP who underwent the Hoffer procedure showed significant enhancement in postoperative ROM, strength, and functional outcome scores. At the time of surgery, individuals younger than 2.5 years generally had better functional outcomes. The results displayed limited preoperative external rotation strength and range of movement were significantly correlated with the requirement for subsequent humeral derotational osteotomy. In this cohort, in the shoulder function, significant improvements were obtained after the Hoffer procedure for BPBP.