The Pathogenesis of Glenohumeral Deformity and Contracture Formation in Obstetric Brachial Plexus Palsy—A Review

• Main Authors: Pontus N. Olofsson, Alice Chu, Aleksandra M. McGrath
• Format: Article
• Language: English
• Published: Georg Thieme Verlag KG 2019-01-01
• Series: Journal of Brachial Plexus and Peripheral Nerve Injury
• Subjects: obstetric brachial plexus palsy; brachial plexus; shoulder contracture; glenohumeral joint dysplasia; internal rotation contracture
• Online Access: http://www.thieme-connect.de/DOI/DOI?10.1055/s-0039-1692420

Contractures of the shoulder joint and glenohumeral joint dysplasia are well known complications to obstetrical brachial plexus palsy. Despite extensive description of these sequelae, the exact pathogenesis remains unknown. The prevailing theory to explain the contractures and glenohumeral joint dysplasia states that upper trunk injury leads to nonuniform muscle recovery and thus imbalance between internal and external rotators of the shoulder. More recently, another explanation has been proposed, hypothesizing that denervation leads to reduced growth of developing muscles and that reinnervation might suppress contracture formation. An understanding of the pathogenesis is desirable for development of effective prophylactic treatment. This article aims to describe the current state of knowledge regarding these important complications.