ANALYSIS OF THE RESULTS OF SURGICAL TREATMENT OF PATIENTS WITH THE CONSEQUENCES OF OBSTETRIC DUCHENNE-ERB PARALYSIS
DOI:
https://doi.org/10.15674/0030-59872025478-86Keywords:
Duchenne-Erb obstetric palsy, shoulder joint, secondary bone deformities, brachial plexus, muscle transpositions, Mallet scale, disease-specific instrumentAbstract
To improve upper limb function in obstetric palsy, a number of surgical techniques have been proposed worldwide. However, achieving the desired rehabilitation effect is not always possible. Objective. To analyze the treatment outcomes in patients with the sequelae of Duchenne–Erb obstetric palsy depending on the severity of pathology, the diagnostic methods applied, and the chosen surgical tactics. Methods. A retrospective and prospective study was conducted to evaluate the treatment outcomes of children with Duchenne–Erb obstetric palsy who underwent surgery at the Pediatric Orthopedics Department of the SI «Sytenko Institute of Spine and Joint Pathology of the National Academy of Medical Sciences of Ukraine». The retrospective group consisted of 6 patients; the prospective group included 16 patients, divided into two subgroups of eight: Group I — without bony deformities; Group II — with secondary bony deformities. Tendon-muscle transfers were performed in Group I, while a two-stage surgical intervention was applied in Group II. Parents of the children completed questionnaires. Results. In the retrospective group, after L’Episcopo surgery, an improvement in the function of the affected limb according to the Mallet scale was observed in two patients, while in the prospective group (in the long-term postoperative period) improvements were recorded in 10 cases. Group II demonstrated more pronounced and statistically significant positive changes in upper-limb function (p < 0.05). The frequency of functional improvement according to the Mallet scale between the prospective and retrospective groups did not reach statistical significance (p > 0.05). Differences in postoperative muscle strength between Groups I and II were not statistically significant (p > 0.05). After treatment, parents’ assessment of their child’s functional status increased by (5.1 ± 1.3) points, satisfaction with life — by (4.3 ± 1.3) points, and overall quality of life — by (9.4 ± 2.6) points (p < 0.001). Conclusions. A differentiated approach to choosing treatment tactics allows not only improving the function of the affected limb but also enhancing patients’ quality of life, improving their psycho-emotional state, and increasing life satisfaction.
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Copyright (c) 2025 Anastasiia Hrytsenko, Sergii Khmyzov, Iryna Harbuzniak, Tatiana Yermak, Ruslan Zlatnik
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