Assessment of Triangle Tilt Surgery in Treatment of Obstetric Brachial Plexus Injury

Abstract

Background: An obstetric brachial plexus injury (OBPI) occurs when the brachial plexus is subjected to severe traction during the labor and delivery procedure. These individuals may see considerable improvements in shoulder function and glenohumeral congruity after undergoing the triangle tilt operation. This research aimed to assess the clinical, functional as well as radiological outcomes of managing obstetric brachial plexus injury using triangle tilt surgery.Methods: Eighteen patients who were treated for obstetric brachial plexus injury using triangle tilt surgery technique in this prospective clinical study with follow up period of at least 24 months clinically and radiological by x-ray and CT of shoulder joints. Postoperative evaluation was performed according to Mallet Score.Results: Posterior supination significantly increased after intervention from 14.16±2.25 to 25.50±2.72 (p<0.001). The measurements of the glenoid version showed significant improvement which was about 29.55±3.27 and improved to be about 22.66±2.95 (p<0.001). There was significant improvement in the abduction angle while preoperative was 78.05±10.72 and became post operative 149±9.85 (p<0.001). There was significant improvement in SHEAR deformity grades while preoperative was grade 3 and grade 4 and became post operative grade 2 (p<0.001). Glenoid version significantly improved from preoperative compared to post operative (p<0.001). Abduction angle significantly increased from pre to post as 78.05±10.72 to 149±9.85 (p<0.001). Nonunion of the clavicular osteotomy happened in 3 cases only and was managed by wire fixation.