Clinical Outcomes of Humeral Derotation Osteotomy in Obstetric Brachial Plexus Palsy: A Retrospective Cohort Study.

Original Article

Abstract

Objective: To evaluate the clinical and functional outcomes of humeral derotation osteotomy in patients with OBPP, with emphasis on improvement in shoulder external rotation, functional scores, and postoperative complications.

Methods: This retrospective cohort study included 46 children with OBPP who underwent HDO at a tertiary orthopedic center. We retrospectively assessed demographic, surgical, radiographic, functional, complication, and follow-up data. We compared shoulder range of motion and Mallet scores preoperatively and postoperatively using paired t-tests.

Results: Mean external rotation improved from −25.6° ± 8.4° to 32.8° ± 10.2°, while abduction increased from 62.5° ± 14.3° to 118.7° ± 16.9% (p<0.001). Mallet scores improved from 9.2 ± 2.1 to 16.8 ± 2.4 (p<0.001). Minor complications included stiffness, implant irritation, and infection.

Conclusion: Humeral derotation osteotomy is an effective surgical procedure for correcting internal rotation deformity in patients with OBPP. It provides significant functional and cosmetic improvement with a low complication rate. Early identification and appropriate surgical intervention can substantially enhance quality of life in affected children.