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We describe the results of surgical treatment in 98 patients (mean age 2.5 years, 0.5 to 9.0) for the correction of active abduction of the shoulder. The patients underwent transfer of the latissimus dorsi and teres major muscles, release of contractures of subscapularis pectoralis major and minor, and axillary nerve decompression and neurolysis (the modified Quad procedure). The transferred muscles were sutured to the teres minor muscle, not to a point of bony insertion. The mean pre-operative active abduction was 45\u00b0 (20\u00b0 to 90\u00b0). At a mean follow-up of 4.8 years (2.0 to 8.7), the mean active abduction was 162\u00b0 (100\u00b0 to 180\u00b0) while 77 (78.6%) of the patients had active abduction of 160\u00b0 or more. No decline in abduction was noted among the 29 patients (29.6%) followed up for six years or more. This procedure involving release of the contracted internal rotators of the shoulder combined with decompression and neurolysis of the axillary nerve greatly improves active abduction in young patients with muscle imbalance secondary to obstetric brachial plexus palsy. <\/jats:p>","DOI":"10.1302\/0301-620x.89b5.18403","type":"journal-article","created":{"date-parts":[[2007,5,31]],"date-time":"2007-05-31T16:08:12Z","timestamp":1180627692000},"page":"620-626","source":"Crossref","is-referenced-by-count":38,"title":["Improvement in abduction of the shoulder after reconstructive soft-tissue procedures in obstetric brachial plexus palsy"],"prefix":"10.1302","volume":"89-B","author":[{"given":"R. K.","family":"Nath","sequence":"first","affiliation":[{"name":"Texas Nerve and Paralysis Institute, 2201 West Holcombe, Boulevard, Houston, Texas, 77030, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Paizi","sequence":"additional","affiliation":[{"name":"Texas Nerve and Paralysis Institute, 2201 West Holcombe, Boulevard, Houston, Texas, 77030, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"42","reference":[{"key":"R1","doi-asserted-by":"publisher","DOI":"10.1054\/bjps.1997.0166"},{"key":"R2","unstructured":"Gilbert A, Tassin JL. Surgical repair of the brachial plexus in obstetric paralysis. Chirurgie 1984;110:70\u20135 (in French)."},{"key":"R3","doi-asserted-by":"crossref","unstructured":"Waters PM. Comparison of the natural history, the outcome of microsurgical repair, and the outcome of operative reconstruction in brachial plexus birth palsy. 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