RESUMEN
Introduction: Supination contracture in patients with obstetrical brachial plexus paralysis [OBPP] results in severe functional limitation of daily activities. Forearm pronation osteotomy has been used to address this problem, although the functional benefit over nonoperative management has not yet been clearly defined
Material and methods: This is a retrospective chart review of children with OBPP who underwent a pronating forearm osteotomy for their supination contracture at our institution between 2007 and 2014. Patients were evaluated for resting forearm position, forearm passive and active pronation and supination, preoperatively and at their last followup. Age correlation to outcomes was also tested. A subjective assessment tool for improvement was also used to evaluate patient-oriented outcomes
Results: Eighteen patients with a mean age of 8.5 years [3.7-17] and a mean follow-up of 55 months [24-100] were included. Preoperatively, patients had a forearm resting position of - 90 degree . Mean passive pronation was -45 degree [-30 degree to - 60 degree]. All patients had no active pronation. At their last follow-up, mean forearm resting position was - 4 degree [- 45 degree to +10 degree ;p < 0.001], mean active pronation was +26 degree [0 degree to +60 degree ; p < 0.001], mean passive pronation reached + 76 degree [+ 50 degree to + 90 degree ; p < 0.001], mean active supination was - 37 degree [- 50 degree to - 25 degree ; [p < 0.001] and mean passive supination was - 80 degree [- 90 degree to - 73 degree ; p < 0.001]. There were no correlation between age at surgery and final outcomes. Subjective self-assessment tool showed a mean partial improvement in all five tested headings
Discussion: Pronation osteotomy in OBPP patients with supination contracture is an effective reliable procedure with reproducible results. It seems to be associated with partially improved functional results in the postoperative period. While recurrence is possible, age at surgical intervention does not seem to affect the final outcome
RESUMEN
Introduction: Several studies suggest the importance of lumbar lordosis [LL] and pelvic parameters [PP] in sagittal balance and their central role in the discovertebral disorders. This radiographic study assesses pelvic parameters by sex and classifies lumbar morphotypes in a population of asymptomatic young subjects
Materials and methods: A sample of 95 asymptomatic young adults free of spinal pathology was recruited for a cross-sectional study. There were 54 men of which one was excluded and 41 women aged between 21 and 30 years. Each participant's pelvic incidence [PI], sacral slope [SS] pelvic tilt [PT] were measured from a lateral radiograph of the lumbar spine in a standing position. In addition, a classification using the 4 morphotypes of Roussouly was made
Results: There was no significant difference in the PI, SS or PT between men and women. The mean value was 51.34[degree sign], 39.85[degree sign] and 11.11[degree sign] for the PI, SS and PT respectively. In addition, 12.76% of the subjects were classified as type 1, 20.21% as type 2, 44.68% as type 3 and 22.34% as type 4
Conclusion: Analysis of this sample gives an idea of the prevalence of each morphotype among asymptomatic Lebanese young adults and the disco-vertebral pathologies that may result. More than half of the subjects are at risk of suffering from such diseases according to the study