Humeral Rotational Osteotomy for Shoulder Deformity in Obstetric Brachial Plexus Palsy: Which Direction Should I Rotate?

The Open Orthopaedics Journal 13 June 2014 RESEARCH ARTICLE DOI: 10.2174/1874325001408010130


Shoulder internal rotation contracture is the most common deformity affecting the shoulder in patients with Obstetric Brachial Plexus Palsy. With progression of the deformity, the glenohumeral joint starts to subluxate and then dislocates. This is accompanied with bony changes of both the humerus and the glenoid. Two opposite direction humeral osteotomies have been proposed for this condition (internal rotation osteotomy (IRO) and external rotation osteotomy (ERO)). This fact of different direction osteotomies has not adequately been explained in the literature. Most orthopedic surgeons may not be able to fully differentiate between these two osteotomies regarding the indications, outcomes and effects on the joint. This review explains these differences in details.

Keywords: Erb's Palsy, external rotation, glenohumeral joint, humeral osteotomy, internal rotation, internal rotation deformity, obstetric brachial plexus palsy (OBPP), shoulder dislocation..
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