Radial osteotomy following tendon transfer in patients with OBPP.
Research type
Research Study
Full title
Rotation osteotomy after tendon transfer to improve supination deformity in patients presenting with C7 brachial plexus injury. Should it be a part of management algorithm?
IRAS ID
232905
Contact name
Andrea Jester
Contact email
Sponsor organisation
Birmingham Children's Hospital
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
Obstetric brachial plexus palsy (OBPP) refers to an injury to the nerves in the neck and shoulder of the newborn during labor. In some of these patients function of the wrist, finger and thumb is affected. In literature a transfer (or repositioning) of a flexor tendon (the flexor carpi ulnaris, FCU) to an extensor tendon (the extensor carpi radialis brevis, ECRB) is reported to produce satisfactory results in the improvement of extension of the wrist. In our institution this transfer is also used as a first choice in correction of a flexed wrist. We noted however that often our patients needed additional surgery in a later stage to correct rotation of the forearm.
The rotation of the forearm could be present prior to, or developed after, the tendon transfer. In the case of the
rotation being present before the transfer, the two surgeries can be combined. However, as the tendon transfer has a strong rotation force, the tendon transfer might be the cause of the rotation deformity. This has so far not been reported in previous studies of this tendon transfers. The main objective of this study will be to assess which of the patients who underwent an FCU to ECRB transfer to correct a flexed wrist deformity, needed a subsequent forearm osteotomy to correct a rotation (supination) deformity, to prevent a second surgery in future patients. Therefore the following research questions will be investigated: (1) was a supination deformity present before performing FCU to ECRB transfer? (2) what are risk factors for the need for an additional osteotomy? (3) Will an additional osteotomy lead to the desired result?REC name
North West - Greater Manchester West Research Ethics Committee
REC reference
18/NW/0086
Date of REC Opinion
9 Mar 2018
REC opinion
Further Information Favourable Opinion