{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T10:56:10Z","timestamp":1792061770042,"version":"4.4.0"},"reference-count":15,"publisher":"British Editorial Society of Bone & Joint Surgery","issue":"8","license":[{"start":{"date-parts":[[2009,8,1]],"date-time":"2009-08-01T00:00:00Z","timestamp":1249084800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/online.boneandjoint.org.uk\/TDM"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Bone and Joint Surgery. British volume"],"published-print":{"date-parts":[[2009,8]]},"abstract":"<jats:p> We retrospectively studied the possibility that direct trauma to the biceps muscle might be the cause of poor elbow flexion and supination in 18 consecutive children with birth lesions of the brachial plexus who had delayed or impaired biceps recovery despite neurophysiological evidence of reinnervation. All had good shoulder and hand function at three months of age. Eight recovered a strong biceps after six months, but nine required a pectoralis minor to biceps transfer to augment elbow flexion and supination. One had a delayed but good recovery of the biceps after microsurgical reconstruction of the plexus. All had a clinical \u2018pseudotumour\u2019 in the biceps muscle, which was biopsied during pectoralis minor transfer in two patients and showed rupture and degeneration of muscle fibres with a fibro-fatty infiltrate, suggesting previous muscle trauma. <\/jats:p><jats:p> Direct muscle trauma is an uncommon but important cause of delayed or impaired biceps recovery after brachial plexus birth injuries. Surgery to reinnervate the biceps muscle will not work if substantial muscle damage is present when a suitable muscle transfer should be considered. <\/jats:p>","DOI":"10.1302\/0301-620x.91b8.22125","type":"journal-article","created":{"date-parts":[[2009,8,3]],"date-time":"2009-08-03T16:23:06Z","timestamp":1249316586000},"page":"1086-1089","source":"Crossref","is-referenced-by-count":3,"title":["Biceps muscle trauma at birth with pseudotumour formation"],"prefix":"10.1302","volume":"91-B","author":[{"given":"P.","family":"MacNamara","sequence":"first","affiliation":[{"name":"Peripheral Nerve Injuries Unit Royal National Orthopaedic Hospital, Brockley Hill, Stanmore HA7 4LP, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Yam","sequence":"additional","affiliation":[{"name":"Department of Hand Surgery Singapore General Hospital, Outram Road, Singapore 169608."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. D.","family":"Horwitz","sequence":"additional","affiliation":[{"name":"Peripheral Nerve Injuries Unit Royal National Orthopaedic Hospital, Brockley Hill, Stanmore HA7 4LP, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"42","reference":[{"key":"R1","unstructured":"Gilbert A, Tassin J. Reparation du plexus brachial. Chirurgie 1984;110:70\u20135 (in French)."},{"key":"R2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.70B4.3403599"},{"key":"R3","doi-asserted-by":"crossref","unstructured":"Kawabata H, Masada K, Tsuyuguchi Y, et al. Early microsurgical reconstruction in birth palsy. Clin Orthop 1987;215:233\u201342.","DOI":"10.1097\/00003086-198702000-00034"},{"key":"R4","doi-asserted-by":"crossref","unstructured":"Smith N, Rowan P, Benson L, Ezaki M, Carter P. Neonatal brachial plexus palsy: outcome of absent biceps function at three months of age. J Bone Joint Surg [Am] 2004;86-A:2163\u201370.","DOI":"10.2106\/00004623-200410000-00006"},{"key":"R5","doi-asserted-by":"publisher","DOI":"10.1017\/S001216220000027X"},{"key":"R6","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. J Bone Joint Surg [Am] 1999;81-A:649\u201359.","DOI":"10.2106\/00004623-199905000-00006"},{"key":"R7","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199404000-00001"},{"key":"R8","unstructured":"Birch R. Birth lesions of the brachial plexus. In: Birch R, Bonney G, Wynn Parry C, eds. Surgical disorders of the peripheral nerves. London: Churchill-Livingstone, 1998:216\u201319."},{"key":"R9","doi-asserted-by":"crossref","unstructured":"Bisinella G, Birch R, Smith S. Neurophysiological prediction of outcome in obstetric lesions of the brachial plexus. J Hand Surg [Br] 2003;28-B:148\u201352.","DOI":"10.1016\/S0266-7681(02)00281-4"},{"key":"R10","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.87B8.15975"},{"key":"R11","unstructured":"Narakas A. Obstetrical brachial plexus injuries. In: Lamb D, ed. The paralyzed hand. Edinburgh: Churchill-Livingstone, 1987:116\u201335."},{"key":"R12","unstructured":"No authors listed. Aids to the examination of the peripheral nervous system. Fourth ed. London: WB Saunders, 2000."},{"key":"R13","unstructured":"Birch R. Reconstruction. In: Bonney G, Wynn Parry C, eds. Surgical disorders of the peripheral nerve. London: Churchill-Livingstone, 1998:415\u2013510."},{"key":"R14","unstructured":"Zancolli EA II. Palliative surgery: pronosupination in obstetrical palsy. In: Gilbert A, ed. brachial plexus injuries. London: Martin Dunitz, 2001:275\u201391."},{"key":"R15","doi-asserted-by":"crossref","unstructured":"Bisinella G, Birch R. Obstetric brachial plexus lesions: a study of 74 children registered with the British Paediatric Surveillance Unit (March 1998 - March 1999). J Hand Surg [Br] 2003;28:40\u20135.","DOI":"10.1054\/JHSB.2002.0841"}],"container-title":["The Journal of Bone and Joint Surgery. 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