Elbow Flexion Contractures in Brachial Plexus Birth Injury Patients
Brachial plexus birth palsy will often lead to elbow flexion contractures. Many of them are minor and require attention in therapy along with splinting or casting to correct or prevent them from worsening. Occasionally, an elbow flexion contractures will worsen with the growth and development of the child. There are many theories as to what causes these contracture including muscle imbalance, impaired muscle growth of the elbow flexor muscles, and co-contraction of agonist/antagonist muscles. Until recently, treatment of these contractures was not very effective. With prolonged loss of motion, first the soft tissues get contracted. Then with growth, the bones making up the elbow joint become permanently deformed. This deformation includes bony overgrowth to form an elongated and broadened of the olecranon.
The fossa or depression in the end of the humerus becomes shallow and too small to accommodate the overgrown olecranon, thus creating a bony block to full extension.
Dr. Price has designed an operation that can permanently and significantly improve the elbow contractures that impair function and alter appearance. Dr. Price has improved and modified the Outerbridge-Kashiwagi operation to benefit patients with Erb’s palsy or brachial plexus birth injury.
The operation narrows and shortens the olecranon, and deepens the olecranon fossa to more closely approximate the normal human anatomy. This is often combined with soft tissue releases in the front of the elbow to restore the ability to more fully extend it.
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“After three false diagnoses from other orthopedic surgeons, we found Dr. Price and finally received a diagnosis that was correct and well-informed. We don’t know what we would have done without him. His medical knowledge supersedes that of many doctors I have been to. Since that first visit, my daughter has suffered from quite a few other injuries, and Dr. Price has always been a source of knowledge and help with her ailments.”
— Ellen, New York, NY
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