Functional Outcomes in Obstetric Brachial Plexus Palsy Following Modified Hoffer Tendon Transfer

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Okyar Altas

Basaksehir Cam and Sakura City Hospital, Turkey

: J Womens Health, Issues Care

Abstract

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Statement of the Problem: The modified Hoffer tendon transfer is a widely used secondary surgical technique for improving shoulder abduction and external rotation in children with Obstetric Brachial Plexus Palsy (OBPP). Despite functional recovery following this procedure, some patients demonstrate limited use of the affected extremity in daily activities. This study investigated the relationship between the active range of motion (ROM) of the upper extremity and functional capacity in children with OBPP who underwent this surgery. Methodology & Theoretical Orientation: The study included 52 children aged 4â??14 years who had undergone shoulder tendon transfer surgery. ROM was measured using a goniometer, and functionality was evaluated with the Brachial Plexus Outcome Measure (BPOM). Finding: Significant correlations were observed between shoulder ROM and BPOM scores. Shoulder flexion (p=0.017; r=0.351) positively correlated with shoulder functionality, while shoulder internal rotation (p=0.001; r=0.481) was associated with self-perceived appearance. Conversely, elbow extension (p<0.001; r=-0.512) showed a negative correlation with activities involving the elbow and forearm. Conclusion & Significance: The study highlights the importance of addressing specific ROM parameters in OBPP treatment and rehabilitation. Improvements in shoulder flexion and internal rotation ROM were linked to better functional outcomes and self-perceived appearance, respectively, while restricted elbow extension negatively impacted forearm-related activities.

Biography

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Okyar Altas is a Hand Surgeon practicing in Istanbul, Turkey. Within hand surgery, he specializes in pediatric hand surgery, obstetric brachial plexus injuries, surgical treatment of cerebral palsy and spastic upper extremity (tendon transfers, bone deformity correction surgeries, all treatments including hyperselective neurectomy), hand trauma and reconstructive microsurgery.