Using the main elbow flexion skin crease as an intraoperative parameter to determine the degree of exorotation needed for humeral derotational osteotomies in upper-type brachial plexus patients

Early Complication of Humeral Derotational Osteotomy Surgery for Obstetric Brachial Plexus as Salvage for a Failed Tendon Transfer. Case Report

In brachial plexus injuries, external rotation in patients with a moderate to severe glenohumeral dysplasia is corrected with derotational humeral osteotomy surgery. The most frequent complications described for this procedure include keloid scar, loss of external rotation secondary to bone remodelling, loss of internal rotation, prominence of osteosynthesis, fracture distal to the plate transient ulnar paraesthesia and radial nerve palsy (1), and delayed union and non-union. Rarely, treating complications associated with derotational humeral osteotomy may require revision of osteosynthesis (2). The literature that investigates the effectiveness of derotational humeral osteotomy as a procedure to rescue dorsal infraspinatus tendon transfer is limited. This article is the first communication of a pediatric patient with an obstetric brachial plexus injury receiving a derotational osteotomy as a procedure to salvage a failed rescue Latissimus dorsi tendon transfer with a complication. This case report was performed according to the principles of the Declaration of Helsinki. Written informed consent for participation in this case report was obtained from the patient's parents.