Author/Editor		Jelerčič, Nataša; Groleger, Katja; Vidmar, Gaj
Title		Napovedni dejavniki okrevanja in funkcijsko stanje pet let starih otrok z obporodno poškodbo brahialnega pleteža po konservativni obravnavi
Translated title		Prognostic factors and functional status of children with obstetric brahial plexus palsy after conservative treatment at age of five years
Type		članek
Source		Rehabilitacija
Vol. and No.		Letnik 10, št. 2
Publication year		2011
Volume		str. 23-9
Language		slo
Abstract		Background: Brachial plexus palsy in newborns (BPP) is rare, but can result in severe and permanent functional impairment of the affected upper limb. There are some methods and formulas for assessment and prediction of recovery after BPP. Treatment is usually conservative, while operative treatment is necessary in some casesč the latter should be followed by long-term (re)habilitation. The aim of the study was to assess the functional status of the children with BPP who were treated conservatively at the age of five years. We compared the functional status at five years with the impairment at tree months and tried to find prognostic values of elbow flexion, LMS (Limb Motion Score) scale and formula for prediction of prognosis. Methods: We included 30 children with BPP conservatively treated at the Department for disabled children Stara Gora of the Nova Gorica General Hospital in the periodfrom 2004 to 2010 into a retrospective study. Data on gender, region, risk factors, side and type of paresis were collected. We assessed the clinical status at the age of three months using LMS score and range of elbow flexion, and tried to predict recovery from the standard formula. We compared the data from the early age and the predicted outcome with data from functional assessment at the age of five years using modified Mallet classification. Results: We confirmed positive prognostic role of LMS score, range of elbow flexion and prediction formula at the age of three months. The prediction formula was the most highly associated with the functional status at the age of five years. There was no statistically significant correlation between gender, risk factors or side of affected upper limb with the outcome. The best functional outcome was observed in children with the Erb type of paresis, followed by those with the Erb plus type; the worst outcome was associated with total paresis of brachial plexus. (Abs. trunc. at 2000 ch.)
Summary		Izhodišča: Poškodba brahialnega pleteža (PBP) pri novorojenčku je redka poškodba, vendar ima lahko za posledico hudo in trajno funkcijsko okvaro zgornjega uda. Izdelali so različne lestvice in klinične formule za funkcijsko oceno in napoved okrevanja. Zdravljenje je večinoma konservativno, včasih pa je potrebno tudi zahtevno kirurško zdravljenje, ki mu sledi dolgotrajen program (re)habilitacije. Z analizo smo želeli ugotoviti, kakšno je funkcijsko stanje otrok po PBP v obdobju novorojenčka in zaključeni konservativni obravnavi. Funkcijsko stanje pet let starih otrok smo hoteli primerjati z njihovim stanjem pri treh mesecih in želeli ugotoviti napovedno vrednost lestvice LMS (Limb Motion Score), sposobnosti za krčenje komolca in formule za izračun prognoze. Metode: V retrogradno analizo je bilo vključenih 30 otrok. Pregledali smo medicinsko dokumentacijo otrok s PBP v obdobju novorojenčka, ki so bili vključeni v konservativno obravnavo na Oddelku za invalidno mladino Stara Gora Splošne bolnišnice Nova Gorica v obdobju od leta 2004 do leta 2010. Razvrstili smo jih po spolu, regiji, dejavnikih tveganja, strani in tipu poškodbe. Funkcijske sposobnosti zgornjega uda smo ocenili z lestvico LMS pri povprečni starosti tri mesece in za napoved okrevanja naredili izračun po formuli. Posebej smo zbrali še podatke o sposobnosti krčenja komolca. Funkcijsko stanje otrok, starih tri do sedem let, smo ocenili s prirejeno Malletovo lestvico. Rezultati: Rezultati kažejo dobro napovedno vrednost lestvice LMS, obsega krčenja v komolcu in formule za izračun prognoze pri otrocih starih 3 mesece. Slednja je bila s funkcijskim stanjem otrok pri petih letih najbolj značilno povezana. Spol, dejavniki tveganja in stran poškodbe niso bili statistično značilno povezani s funkcijskim stanjem otrok pri petih letih, ugotovili pa smo značilno povezanost med tipom poškodbe in funkcijskim stanjem pri petih letih. (Izvl. skrajšan na 2000 zn.)
Descriptors		INFANT, NEWBORN ELBOW PROGNOSIS