J Brachial Plex Peripher Nerve Inj 2012; 07(01): e15-e21
DOI: 10.1186/1749-7221-7-9
Research article
Soldado et al.; licensee BioMed Central Ltd.

Muscular and glenohumeral changes in the shoulder after brachial plexus birth palsy: an MRI study in a rat model[*]

Francisco Soldado
1   Vall Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
,
David Benito-Castillo
2   Orthopedic surgery. Fundació Hospital de l’Esperit Sant, Barcelona, Spain
,
Cesar G Fontecha
1   Vall Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
,
Ignasi Barber
3   Paediatric Radiology Department, Barcelona, Spain
,
Mario Marotta
1   Vall Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
,
Sleiman Haddad
1   Vall Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
,
Mariano E Menendez
1   Vall Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
,
Vasco V Mascarenhas
4   UIME, Centro de Imagiologia, ES Saude Lisboa, Hospital da Luz, Lisboa, Portugal
,
Scott H Kozin
5   Shriners Hospital for Children. Department of Orthopaedic Surgery, Temple University & Hand Surgeon, Philadelphia, PA, USA
› Author Affiliations

Subject Editor:
Further Information

Publication History

20 May 2012

02 December 2012

Publication Date:
24 September 2014 (online)

Abstract

Background Shoulder abnormalities are the major cause of morbidity in upper brachial plexus birth palsy (BPBP). We developed a rat model of upper trunk BPBP and compared our findings to previously reported animal models and to clinical findings in humans.

Methods Forty-three 5-day-old newborn rats underwent selective upper trunk neurectomy of the right brachial plexus and were studied 3 to 20 weeks after surgery. The passive shoulder external rotation was measured and the shoulder joint was assessed bilaterally by a 7.2T MRI bilaterally.

Results We found a marked decrease in passive shoulder external rotation, associated with a severe subscapularis muscle atrophy and contracture. None however developed the typical pattern of glenohumeral dysplasia.

Conclusions In contradiction with previous reports, our study shows that the rat model is not adequate for preclinical studies of shoulder dysplasia. However, it might serve as a useful model for studies analyzing shoulder contracture occurring after upper BPBP.

*This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


 
  • References

  • 1 Pearl ML. Shoulder problems in children with brachial plexus birth palsy: Evaluation and management. J Am Acad Orthop Surg 2009; 17 (4) 242-54 19307673
  • 2 Kozin SH. Correlation between external rotation of the glenohumeral joint and deformity after brachial plexus birth palsy. J Pediatr Orthop 2004; 24 (2) 189-93 10.1097/01241398-200403000-00011 15076606
  • 3 Van der Sluijs JA, van Ouwerkerk WJ, De Gast A, Wuisman PI, Nollet F, Manoliu RA. Deformities of the shoulder in infants younger than 12 months with an obstetric lesion of the brachial plexus. J Bone Joint Surg Br 2001; 83 (4) 551-555 10.1302/0301-620X.83B4.11205 11380130
  • 4 Waters PM, Smith GR, Jaramillo D. Glenohumeral deformity secondary to brachial plexus birth palsy. J Bone Joint Surg 1998; 80 (5) 668 9611027
  • 5 Einarsson F, Hultgren T, Ljung BO, Runesson E, Fridén J. Subscapularis muscle mechanics in children with obstetric brachial plexus palsy. J Hand Surg Eur Vol 2008; 33 (4) 507-12 10.1177/1753193408090764 18687840
  • 6 Hogendoorn S, van Overvest KL, Watt I, Duijsens AH, Nelissen RG. Structural changes in muscle and glenohumeral joint deformity in neonatal brachial plexus palsy. J Bone Joint Surg Am 2010; 92 (4) 935-42 10.2106/JBJS.I.00193 20360518
  • 7 Pöyhiä TH, Nietosvaara YA, Remes VM, Kirjavainen MO, Peltonen JI, Lamminen AE. MRI of rotator cuff muscle atrophy in relation to glenohumeral joint incongruence in brachial plexus birth injury. Pediatr Radiol 2005; 35 (4) 402-9 10.1007/s00247-004-1377-3 15635469
  • 8 Li Z, Ma J, Apel P, Carlson CS, Smith TL, Koman LA. Brachial plexus birth palsy-associated shoulder deformity: A rat model study. J Hand Surg Am 2008; 33 (3) 308-12 10.1016/j.jhsa.2007.11.017 18343282
  • 9 Li Z, Barnwell J, Tan J, Koman LA, Smith BP. Microcomputed tomography characterization of shoulder osseous deformity after brachial plexus birth palsy: a rat model study. J Bone Joint Surg Am 2010; 92 (15) 2583-8 10.2106/JBJS.I.01660 21048177
  • 10 Kim HM, Galatz LM, Das R, Patel N, Thomopoulos S. Musculoskeletal deformities secondary to neurotomy of the superior trunk of the brachial plexus in neonatal mice. J Orthop Res 2010; 28 (10) 1391-8 10.1002/jor.21128 2892643 20225283
  • 11 Kozin SH, Boardman MJ, Chafetz RS, Williams GR, Hanlon A. Arthroscopic treatment of internal rotation contracture and glenohumeral dysplasia in children with brachial plexus birth palsy. J Shoulder Elbow Surg 2010; 19 (1) 102-10 10.1016/j.jse.2009.05.011 19664938
  • 12 Moukoko D, Ezaki M, Wilkes D, Carter P. Posterior shoulder dislocation in infants with neonatal brachial plexus palsy. J Bone Joint Surg Am 2004; 86-A (04) 787-93 15069145
  • 13 Pöyhiä TH, Lamminen AE, Peltonen JI. Brachial plexus birth injury: US screening for glenohumeral joint instability. Radiology 2010; 254 (1) 253-60 10.1148/radiol.09090570 20032156
  • 14 Bertelli JA, Mira J, Gilbert C. Anatomical basis of rat brachial plexus reconstruction. Surg Radiol Anat 1992; 14 (1) 85-86 10.1007/BF01628049 1589853
  • 15 Ochiai H, Ikeda T, Mishima K, Yoshikawa T, Aoo N, Iwasaki K. Development of a novel experimental rat model for neonatal pre-ganglionic upper brachial plexus injury. J Neurosci Methods 2002; 119 (1) 51-7 10.1016/S0165-0270(02)00167-X 12234635
  • 16 Kozin SH, Chafetz RS, Barus D, Filipone L. Magnetic resonance imaging and clinical findings before and after tendon transfers about the shoulder in children with residual brachial plexus birth palsy. J Shoulder Elbow Surg 2006; 15 (5) 554-61 10.1016/j.jse.2005.11.004 16979049
  • 17 Soldado F, Kozin SH. The relationship between the coracoid and glenoid after brachial plexus birth palsy. J Pediatr Orthop 2005; 25 (5) 666-670 10.1097/01.bpo.0000164873.41485.19 16199952
  • 18 Waters PM, Monica JT, Earp BE, Zurakowski D, Bae DS. Correlation of radiographic muscle cross-sectional area with glenohumeral deformity in children with brachial plexus birth palsy. J Bone Joint Surg Am 2009; 91 (10) 2367-75 10.2106/JBJS.H.00417 19797571
  • 19 Nikolaou S, Peterson E, Kim A, Wylie C, Cornwall R. Impaired growth of denervated muscle contributes to contracture formation following neonatal brachial plexus injury. J Bone Joint Surg Am 2011; 93 (5) 461-70 10.2106/JBJS.J.00943 21368078
  • 20 Van Gelein Vitringa VM, van Kooten EO, Jaspers RT, Mullender MG, van Doorn-Loogman MH, van der Sluijs JA. An MRI study on the relations between muscle atrophy, shoulder function and glenohumeral deformity in shoulders of children with obstetric brachial plexus injury. J Brachial Plex Peripher Nerve Inj 2009; 4: 9 10.1186/1749-7221-4-9 2713227 19586542
  • 21 Clarke SE, Chafetz RS, Kozin SH. Ossification of the proximal humerus in children with residual brachial plexus birth palsy: A magnetic resonance imaging study. J Pediatr Orthop 2010; 30 (1) 60-6 10.1097/BPO.0b013e3181c6c344 20032744