Morbidity of Nerve Transfers for Brachial Plexus Birth Injury: A Systematic Review.


Journal

Journal of pediatric orthopedics
ISSN: 1539-2570
Titre abrégé: J Pediatr Orthop
Pays: United States
ID NLM: 8109053

Informations de publication

Date de publication:
01 Feb 2021
Historique:
pubmed: 13 11 2020
medline: 15 5 2021
entrez: 12 11 2020
Statut: ppublish

Résumé

The purpose of this article is to systematically review the peer-reviewed literature on the morbidity of nerve transfers performed in patients with brachial plexus birth injury (BPBI). Nerve transfers for restoration of function in patients with BPBI that fail nonoperative management are increasing in popularity. However, relatively little attention has been paid to the morbidity of these transfers in the growing patient. The authors systematically review the current literature regarding donor site morbidity following nerve transfer for BPBI. A systematic review of the Medline and EMBASE databases was conducted through February 2020. Primary research articles written in English and reporting donor site morbidity after nerve transfer for BPBI were included for review. Thirty-six articles met inclusion criteria, all of which were retrospective reviews or case reports. There was great heterogeneity in outcomes assessed. With 5 year or less follow-up, all transfers were relatively well tolerated with the exception of the hypoglossal nerve transfer. Nerve transfers are a well-recognized treatment strategy for patients with BPBI and have an acceptable risk profile in the short term. Full hypoglossal nerve transfers for BPBI are of historical interest. Donor site morbidity is grossly underreported. This review highlights the need for more objective and systematic reporting of donor site outcomes, and the need for longer term follow-up in these patients. Systematic review. Level III-therapeutic.

Sections du résumé

BACKGROUND BACKGROUND
The purpose of this article is to systematically review the peer-reviewed literature on the morbidity of nerve transfers performed in patients with brachial plexus birth injury (BPBI). Nerve transfers for restoration of function in patients with BPBI that fail nonoperative management are increasing in popularity. However, relatively little attention has been paid to the morbidity of these transfers in the growing patient. The authors systematically review the current literature regarding donor site morbidity following nerve transfer for BPBI.
METHODS METHODS
A systematic review of the Medline and EMBASE databases was conducted through February 2020. Primary research articles written in English and reporting donor site morbidity after nerve transfer for BPBI were included for review.
RESULTS RESULTS
Thirty-six articles met inclusion criteria, all of which were retrospective reviews or case reports. There was great heterogeneity in outcomes assessed. With 5 year or less follow-up, all transfers were relatively well tolerated with the exception of the hypoglossal nerve transfer.
CONCLUSION CONCLUSIONS
Nerve transfers are a well-recognized treatment strategy for patients with BPBI and have an acceptable risk profile in the short term. Full hypoglossal nerve transfers for BPBI are of historical interest. Donor site morbidity is grossly underreported. This review highlights the need for more objective and systematic reporting of donor site outcomes, and the need for longer term follow-up in these patients.
LEVEL OF EVIDENCE METHODS
Systematic review. Level III-therapeutic.

Identifiants

pubmed: 33177353
pii: 01241398-202102000-00026
doi: 10.1097/BPO.0000000000001705
doi:

Types de publication

Journal Article Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

e188-e198

Informations de copyright

Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

Déclaration de conflit d'intérêts

The authors declare no conflicts of interest.

Références

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Auteurs

Katharine M Hinchcliff (KM)

Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN.

Nicholas Pulos (N)

Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN.

Alexander Y Shin (AY)

Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN.

Christopher Stutz (C)

Department of Orthopedic Surgery, Texas Scottish Rite Hospital, Dallas, TX.

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