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Shoulder Contracture and Osseous Deformity in Obstetrical Brachial Plexus Injuries
BackgroundThe purposes of this study were to determine the prevalence of and the association between shoulder contracture and osseous deformity in a cohort of children with an obstetrical brachial plexus injury and to identify the risk factors for these complications.MethodsIn a retrospective cohort...
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| Published in: | Journal of bone and joint surgery. American volume 2003-02, Vol.85 (2), p.316-322 |
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| container_title | Journal of bone and joint surgery. American volume |
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| creator | Hoeksma, Agnes F ter Steeg, Anne Marie Dijkstra, Piet Nelissen, Rob G.H.H Beelen, Anita de Jong, Bareld A |
| description | BackgroundThe purposes of this study were to determine the prevalence of and the association between shoulder contracture and osseous deformity in a cohort of children with an obstetrical brachial plexus injury and to identify the risk factors for these complications.MethodsIn a retrospective cohort study, all children with an obstetrical brachial plexus injury who had been born between January 1991 and January 1998 at one academic medical center and all those with the same diagnosis who had been born elsewhere during the same period and were referred to the medical center within six weeks after delivery were evaluated at fixed time-intervals by one examiner. The patients underwent a final orthopaedic, neurological, and radiographic examination at a mean age of 3.7 years (range, one to seven years). Shoulder contracture was defined as a decrease in the passive range of motion in one or more directions compared with the range on the unaffected side. Osseous deformity was defined as a nonspherical humeral head or an abnormal glenoid.ResultsThe prevalence of a shoulder contracture of >10° was 56% (twenty-nine of fifty-two patients), and the prevalence of an osseous deformity was 33% (sixteen of forty-eight patients with complete radiographic follow-up). In the children in whom complete neurological recovery was delayed (i.e., recovery was more than three weeks after birth), the prevalence of shoulder contracture was 54% (thirteen of twenty-four patients) and the prevalence of osseous deformity was 26% (six of twenty-three patients). A strong association was noted between shoulder contracture and osseous deformity (p = 0.004). Directly after birth, the presence of a clavicular fracture was the only factor that was associated (p = 0.016) with the development of an osseous deformity (but not with a shoulder contracture). At a later stage, speed and extent of neurological recovery were related to shoulder contracture and osseous deformity. An asymmetric appearance was noticed in children who had a contracture, including those who had complete neurological recovery.ConclusionsThe prevalence of shoulder contracture and osseous deformity in children with obstetrical brachial plexus injury was high, even in those with complete neurological recovery. These complications were strongly associated with one another. No symptom that appeared immediately after birth was identified as a factor that would predict the development of future shoulder contracture. A clavicular fr |
| doi_str_mv | 10.2106/00004623-200302000-00020 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_miscellaneous_73007151</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>285995981</sourcerecordid><originalsourceid>FETCH-LOGICAL-p3090-2835011718063a8453b43ab0c227cef32c8f11f8a7beb10967ed8f70ee04a0a93</originalsourceid><addsrcrecordid>eNp10etLwzAQAPAgis7HvyBF0G_Vu1zTdB91PkGY-Phc0u7KOrN2Ji3T_96MTQTBQB6E34W7ixARwrlESC8gjCSVFEsAgrBAHKaELTFARSpGytJtMQhXGA9JqT2x7_1sFZSA3hV7KJVGQhyI55dp29sJu2jUNp0zZdc7jkwzicbec9v76Jqr1s3r7iuqm2hc-I47V5fGRldBT-tweLL8GeBDM-tdzf5Q7FTGej7a7Afi7fbmdXQfP47vHkaXj_GCYAixzEgBosYMUjJZoqhIyBRQSqlLrkiWWYVYZUYXXCAMU82TrNLADIkBM6QDcbZ-d-Haj559l89rX7K1plklnmsC0KgwwJM_cNb2rgm55RIUpoiZDOh4g_pizpN84eq5cV_5T6sCON0A40P5lTNNWftfl2gikiq4ZO2Wre3Y-XfbL9nlUza2m-b__Rx9A5wDh0w</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>205161182</pqid></control><display><type>article</type><title>Shoulder Contracture and Osseous Deformity in Obstetrical Brachial Plexus Injuries</title><source>HEAL-Link subscriptions: Lippincott Williams & Wilkins</source><creator>Hoeksma, Agnes F ; ter Steeg, Anne Marie ; Dijkstra, Piet ; Nelissen, Rob G.H.H ; Beelen, Anita ; de Jong, Bareld A</creator><creatorcontrib>Hoeksma, Agnes F ; ter Steeg, Anne Marie ; Dijkstra, Piet ; Nelissen, Rob G.H.H ; Beelen, Anita ; de Jong, Bareld A</creatorcontrib><description>BackgroundThe purposes of this study were to determine the prevalence of and the association between shoulder contracture and osseous deformity in a cohort of children with an obstetrical brachial plexus injury and to identify the risk factors for these complications.MethodsIn a retrospective cohort study, all children with an obstetrical brachial plexus injury who had been born between January 1991 and January 1998 at one academic medical center and all those with the same diagnosis who had been born elsewhere during the same period and were referred to the medical center within six weeks after delivery were evaluated at fixed time-intervals by one examiner. The patients underwent a final orthopaedic, neurological, and radiographic examination at a mean age of 3.7 years (range, one to seven years). Shoulder contracture was defined as a decrease in the passive range of motion in one or more directions compared with the range on the unaffected side. Osseous deformity was defined as a nonspherical humeral head or an abnormal glenoid.ResultsThe prevalence of a shoulder contracture of >10° was 56% (twenty-nine of fifty-two patients), and the prevalence of an osseous deformity was 33% (sixteen of forty-eight patients with complete radiographic follow-up). In the children in whom complete neurological recovery was delayed (i.e., recovery was more than three weeks after birth), the prevalence of shoulder contracture was 54% (thirteen of twenty-four patients) and the prevalence of osseous deformity was 26% (six of twenty-three patients). A strong association was noted between shoulder contracture and osseous deformity (p = 0.004). Directly after birth, the presence of a clavicular fracture was the only factor that was associated (p = 0.016) with the development of an osseous deformity (but not with a shoulder contracture). At a later stage, speed and extent of neurological recovery were related to shoulder contracture and osseous deformity. An asymmetric appearance was noticed in children who had a contracture, including those who had complete neurological recovery.ConclusionsThe prevalence of shoulder contracture and osseous deformity in children with obstetrical brachial plexus injury was high, even in those with complete neurological recovery. These complications were strongly associated with one another. No symptom that appeared immediately after birth was identified as a factor that would predict the development of future shoulder contracture. A clavicular fracture was found to be significantly associated with the development of an osseous deformity at a later stage.Level of EvidencePrognostic study, Level II-1 (retrospective study). See Instructions to Authors for a complete description of levels of evidence.</description><edition>American volume</edition><identifier>ISSN: 0021-9355</identifier><identifier>EISSN: 1535-1386</identifier><identifier>DOI: 10.2106/00004623-200302000-00020</identifier><identifier>PMID: 12571311</identifier><identifier>CODEN: JBJSA3</identifier><language>eng</language><publisher>Boston, MA: Copyright by The Journal of Bone and Joint Surgery, Incorporated</publisher><subject>Biological and medical sciences ; Birth Injuries - complications ; Brachial Plexus Neuropathies - etiology ; Child ; Child, Preschool ; Clavicle - injuries ; Cohort Studies ; Contracture - epidemiology ; Contracture - etiology ; Cranial nerves. Spinal roots. Peripheral nerves. Autonomic nervous system. Gustation. Olfaction ; Diseases of the osteoarticular system ; Female ; Fractures, Bone - complications ; Humans ; Infant ; Infant, Newborn ; Joint Deformities, Acquired - epidemiology ; Joint Deformities, Acquired - etiology ; Male ; Medical sciences ; Miscellaneous. Osteoarticular involvement in other diseases ; Nervous system (semeiology, syndromes) ; Neurology ; Pregnancy ; Prevalence ; Recovery of Function ; Retrospective Studies ; Risk Factors ; Shoulder Joint - pathology</subject><ispartof>Journal of bone and joint surgery. American volume, 2003-02, Vol.85 (2), p.316-322</ispartof><rights>Copyright 2003 by The Journal of Bone and Joint Surgery, Incorporated</rights><rights>2003 INIST-CNRS</rights><rights>Copyright Journal of Bone and Joint Surgery, Inc. Feb 2003</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,786,790,27957,27958</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=14733325$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12571311$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hoeksma, Agnes F</creatorcontrib><creatorcontrib>ter Steeg, Anne Marie</creatorcontrib><creatorcontrib>Dijkstra, Piet</creatorcontrib><creatorcontrib>Nelissen, Rob G.H.H</creatorcontrib><creatorcontrib>Beelen, Anita</creatorcontrib><creatorcontrib>de Jong, Bareld A</creatorcontrib><title>Shoulder Contracture and Osseous Deformity in Obstetrical Brachial Plexus Injuries</title><title>Journal of bone and joint surgery. American volume</title><addtitle>J Bone Joint Surg Am</addtitle><description>BackgroundThe purposes of this study were to determine the prevalence of and the association between shoulder contracture and osseous deformity in a cohort of children with an obstetrical brachial plexus injury and to identify the risk factors for these complications.MethodsIn a retrospective cohort study, all children with an obstetrical brachial plexus injury who had been born between January 1991 and January 1998 at one academic medical center and all those with the same diagnosis who had been born elsewhere during the same period and were referred to the medical center within six weeks after delivery were evaluated at fixed time-intervals by one examiner. The patients underwent a final orthopaedic, neurological, and radiographic examination at a mean age of 3.7 years (range, one to seven years). Shoulder contracture was defined as a decrease in the passive range of motion in one or more directions compared with the range on the unaffected side. Osseous deformity was defined as a nonspherical humeral head or an abnormal glenoid.ResultsThe prevalence of a shoulder contracture of >10° was 56% (twenty-nine of fifty-two patients), and the prevalence of an osseous deformity was 33% (sixteen of forty-eight patients with complete radiographic follow-up). In the children in whom complete neurological recovery was delayed (i.e., recovery was more than three weeks after birth), the prevalence of shoulder contracture was 54% (thirteen of twenty-four patients) and the prevalence of osseous deformity was 26% (six of twenty-three patients). A strong association was noted between shoulder contracture and osseous deformity (p = 0.004). Directly after birth, the presence of a clavicular fracture was the only factor that was associated (p = 0.016) with the development of an osseous deformity (but not with a shoulder contracture). At a later stage, speed and extent of neurological recovery were related to shoulder contracture and osseous deformity. An asymmetric appearance was noticed in children who had a contracture, including those who had complete neurological recovery.ConclusionsThe prevalence of shoulder contracture and osseous deformity in children with obstetrical brachial plexus injury was high, even in those with complete neurological recovery. These complications were strongly associated with one another. No symptom that appeared immediately after birth was identified as a factor that would predict the development of future shoulder contracture. A clavicular fracture was found to be significantly associated with the development of an osseous deformity at a later stage.Level of EvidencePrognostic study, Level II-1 (retrospective study). See Instructions to Authors for a complete description of levels of evidence.</description><subject>Biological and medical sciences</subject><subject>Birth Injuries - complications</subject><subject>Brachial Plexus Neuropathies - etiology</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Clavicle - injuries</subject><subject>Cohort Studies</subject><subject>Contracture - epidemiology</subject><subject>Contracture - etiology</subject><subject>Cranial nerves. Spinal roots. Peripheral nerves. Autonomic nervous system. Gustation. Olfaction</subject><subject>Diseases of the osteoarticular system</subject><subject>Female</subject><subject>Fractures, Bone - complications</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Joint Deformities, Acquired - epidemiology</subject><subject>Joint Deformities, Acquired - etiology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Miscellaneous. Osteoarticular involvement in other diseases</subject><subject>Nervous system (semeiology, syndromes)</subject><subject>Neurology</subject><subject>Pregnancy</subject><subject>Prevalence</subject><subject>Recovery of Function</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Shoulder Joint - pathology</subject><issn>0021-9355</issn><issn>1535-1386</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><recordid>eNp10etLwzAQAPAgis7HvyBF0G_Vu1zTdB91PkGY-Phc0u7KOrN2Ji3T_96MTQTBQB6E34W7ixARwrlESC8gjCSVFEsAgrBAHKaELTFARSpGytJtMQhXGA9JqT2x7_1sFZSA3hV7KJVGQhyI55dp29sJu2jUNp0zZdc7jkwzicbec9v76Jqr1s3r7iuqm2hc-I47V5fGRldBT-tweLL8GeBDM-tdzf5Q7FTGej7a7Afi7fbmdXQfP47vHkaXj_GCYAixzEgBosYMUjJZoqhIyBRQSqlLrkiWWYVYZUYXXCAMU82TrNLADIkBM6QDcbZ-d-Haj559l89rX7K1plklnmsC0KgwwJM_cNb2rgm55RIUpoiZDOh4g_pizpN84eq5cV_5T6sCON0A40P5lTNNWftfl2gikiq4ZO2Wre3Y-XfbL9nlUza2m-b__Rx9A5wDh0w</recordid><startdate>200302</startdate><enddate>200302</enddate><creator>Hoeksma, Agnes F</creator><creator>ter Steeg, Anne Marie</creator><creator>Dijkstra, Piet</creator><creator>Nelissen, Rob G.H.H</creator><creator>Beelen, Anita</creator><creator>de Jong, Bareld A</creator><general>Copyright by The Journal of Bone and Joint Surgery, Incorporated</general><general>Journal of Bone and Joint Surgery Incorporated</general><general>Journal of Bone and Joint Surgery AMERICAN VOLUME</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>3V.</scope><scope>7QL</scope><scope>7QO</scope><scope>7QP</scope><scope>7RV</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>200302</creationdate><title>Shoulder Contracture and Osseous Deformity in Obstetrical Brachial Plexus Injuries</title><author>Hoeksma, Agnes F ; ter Steeg, Anne Marie ; Dijkstra, Piet ; Nelissen, Rob G.H.H ; Beelen, Anita ; de Jong, Bareld A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p3090-2835011718063a8453b43ab0c227cef32c8f11f8a7beb10967ed8f70ee04a0a93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Biological and medical sciences</topic><topic>Birth Injuries - complications</topic><topic>Brachial Plexus Neuropathies - etiology</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Clavicle - injuries</topic><topic>Cohort Studies</topic><topic>Contracture - epidemiology</topic><topic>Contracture - etiology</topic><topic>Cranial nerves. Spinal roots. Peripheral nerves. Autonomic nervous system. Gustation. Olfaction</topic><topic>Diseases of the osteoarticular system</topic><topic>Female</topic><topic>Fractures, Bone - complications</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Joint Deformities, Acquired - epidemiology</topic><topic>Joint Deformities, Acquired - etiology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Miscellaneous. Osteoarticular involvement in other diseases</topic><topic>Nervous system (semeiology, syndromes)</topic><topic>Neurology</topic><topic>Pregnancy</topic><topic>Prevalence</topic><topic>Recovery of Function</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Shoulder Joint - pathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hoeksma, Agnes F</creatorcontrib><creatorcontrib>ter Steeg, Anne Marie</creatorcontrib><creatorcontrib>Dijkstra, Piet</creatorcontrib><creatorcontrib>Nelissen, Rob G.H.H</creatorcontrib><creatorcontrib>Beelen, Anita</creatorcontrib><creatorcontrib>de Jong, Bareld A</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>Virology and AIDS Abstracts</collection><collection>ProQuest Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>ProQuest Science Journals</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of bone and joint surgery. American volume</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hoeksma, Agnes F</au><au>ter Steeg, Anne Marie</au><au>Dijkstra, Piet</au><au>Nelissen, Rob G.H.H</au><au>Beelen, Anita</au><au>de Jong, Bareld A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Shoulder Contracture and Osseous Deformity in Obstetrical Brachial Plexus Injuries</atitle><jtitle>Journal of bone and joint surgery. American volume</jtitle><addtitle>J Bone Joint Surg Am</addtitle><date>2003-02</date><risdate>2003</risdate><volume>85</volume><issue>2</issue><spage>316</spage><epage>322</epage><pages>316-322</pages><issn>0021-9355</issn><eissn>1535-1386</eissn><coden>JBJSA3</coden><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>BackgroundThe purposes of this study were to determine the prevalence of and the association between shoulder contracture and osseous deformity in a cohort of children with an obstetrical brachial plexus injury and to identify the risk factors for these complications.MethodsIn a retrospective cohort study, all children with an obstetrical brachial plexus injury who had been born between January 1991 and January 1998 at one academic medical center and all those with the same diagnosis who had been born elsewhere during the same period and were referred to the medical center within six weeks after delivery were evaluated at fixed time-intervals by one examiner. The patients underwent a final orthopaedic, neurological, and radiographic examination at a mean age of 3.7 years (range, one to seven years). Shoulder contracture was defined as a decrease in the passive range of motion in one or more directions compared with the range on the unaffected side. Osseous deformity was defined as a nonspherical humeral head or an abnormal glenoid.ResultsThe prevalence of a shoulder contracture of >10° was 56% (twenty-nine of fifty-two patients), and the prevalence of an osseous deformity was 33% (sixteen of forty-eight patients with complete radiographic follow-up). In the children in whom complete neurological recovery was delayed (i.e., recovery was more than three weeks after birth), the prevalence of shoulder contracture was 54% (thirteen of twenty-four patients) and the prevalence of osseous deformity was 26% (six of twenty-three patients). A strong association was noted between shoulder contracture and osseous deformity (p = 0.004). Directly after birth, the presence of a clavicular fracture was the only factor that was associated (p = 0.016) with the development of an osseous deformity (but not with a shoulder contracture). At a later stage, speed and extent of neurological recovery were related to shoulder contracture and osseous deformity. An asymmetric appearance was noticed in children who had a contracture, including those who had complete neurological recovery.ConclusionsThe prevalence of shoulder contracture and osseous deformity in children with obstetrical brachial plexus injury was high, even in those with complete neurological recovery. These complications were strongly associated with one another. No symptom that appeared immediately after birth was identified as a factor that would predict the development of future shoulder contracture. A clavicular fracture was found to be significantly associated with the development of an osseous deformity at a later stage.Level of EvidencePrognostic study, Level II-1 (retrospective study). See Instructions to Authors for a complete description of levels of evidence.</abstract><cop>Boston, MA</cop><pub>Copyright by The Journal of Bone and Joint Surgery, Incorporated</pub><pmid>12571311</pmid><doi>10.2106/00004623-200302000-00020</doi><tpages>7</tpages><edition>American volume</edition></addata></record> |
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| ispartof | Journal of bone and joint surgery. American volume, 2003-02, Vol.85 (2), p.316-322 |
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| subjects | Biological and medical sciences Birth Injuries - complications Brachial Plexus Neuropathies - etiology Child Child, Preschool Clavicle - injuries Cohort Studies Contracture - epidemiology Contracture - etiology Cranial nerves. Spinal roots. Peripheral nerves. Autonomic nervous system. Gustation. Olfaction Diseases of the osteoarticular system Female Fractures, Bone - complications Humans Infant Infant, Newborn Joint Deformities, Acquired - epidemiology Joint Deformities, Acquired - etiology Male Medical sciences Miscellaneous. Osteoarticular involvement in other diseases Nervous system (semeiology, syndromes) Neurology Pregnancy Prevalence Recovery of Function Retrospective Studies Risk Factors Shoulder Joint - pathology |
| title | Shoulder Contracture and Osseous Deformity in Obstetrical Brachial Plexus Injuries |
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