Obstetrik Brakiyal Pleksus Felci Hastalarında Üst Ekstremite Uzunluklarının İncelenmesi

Abstract

Obstetric Brachial Plexus Palsy (OBPP) is one of the most significant and longstanding issues of the departments of obstetrics and orthopaedics and continues to cause social and psychological pressure on patients, parents and also physicians. Physical reflections of the disease involve a wide range of pathological spectrum like muscle imbalances around upper extremity and shoulder to deformities and joint dysplasias. The relation between nerves and musculoskeletal system has known certainly from 19th century until now. Most of the studies had demonstrated that, after the denervation of the nerves that inervate muscle tissue around long bones, have caused decreasing the growth of these bones. One of the question coming from OBPP patients' parents is: whether or not upper extremity of their children will become shorten. Shortness of upper extremity will cause a problem both in cosmetic and functional terms. In this dissertation study, our primary goal is to determine whether or not an upper limb length discrepancy exists in Obstetric Brachial Plexus Palsy. Apart from that, this study also evaluates the effect of age, side, stage of Narakas Classification and whether they had before surgery, to degree of discrepancy. If we look at the result of this study, it could be seen that paralyzed side is significantly shorter than the healthy ones in the patients of OBPP. Shortness percent (except ulna) that arises parallel to age is seen to be gradually increased. This study unsurprisingly shows that there is no connection between shortness to side and sexuality. Despite this shortness can be seen in all bones at all types of plexopathy, amount of shortness at the bones of forearm in total plexopathies is more than the plexopathy that only the upper truncus damaged. In the light of this study, a detached type of answer could be given to the question of parents as to whether the existence of upper extremity length discrepancy of the children that had OBPP.