{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T10:46:50Z","timestamp":1789728410533,"version":"4.0.1"},"reference-count":25,"publisher":"British Editorial Society of Bone & Joint Surgery","issue":"10","license":[{"start":{"date-parts":[[2013,10,1]],"date-time":"2013-10-01T00:00:00Z","timestamp":1380585600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/online.boneandjoint.org.uk\/TDM"}],"content-domain":{"domain":["online.boneandjoint.org.uk"],"crossmark-restriction":true},"short-container-title":["The Bone &amp; Joint Journal"],"published-print":{"date-parts":[[2013,10]]},"abstract":"<jats:p> We evaluated results at one year after surgical correction of internal rotation deformities in the shoulders of 270 patients with obstetric brachial plexus palsy. The mean age at surgery was 6.2 years (0.6 to 35). Two techniques were used: open subscapularis elongation and latissimus dorsi to infraspinatus transfer. In addition, open relocation was performed or attempted in all patients with subluxed or dislocated joints. A mixed effects model approach was used to evaluate the effects of surgery on internal and external rotation, abduction, flexion and Mallet score. Independent factors included operative status (pre- or post-operative), gender, age, the condition of the joint, and whether or not transfer was performed. The overall mean improvement in external rotation following surgery was 84.6\u00b0 (95% confidence interval (CI) 80.2 to 89.1) and the mean Mallet score improved by 4.0 (95% CI 3.7 to 4.2). There was a mean decrease in internal rotation of between 27.6\u00b0 and 34.4\u00b0 in the relocated joint groups and 8.6\u00b0 (95% CI 5.2 to 12.0) in the normal joint group. Abduction and flexion were unchanged following surgery. Adding a latissimus dorsi transfer did not result in greater improvement in the mean external rotation compared with elongation of the subscapularis alone. <\/jats:p><jats:p> Cite this article: Bone Joint J 2013;95-B:1432\u20138. <\/jats:p>","DOI":"10.1302\/0301-620x.95b10.32049","type":"journal-article","created":{"date-parts":[[2013,9,27]],"date-time":"2013-09-27T15:59:25Z","timestamp":1380297565000},"page":"1432-1438","update-policy":"https:\/\/doi.org\/10.1302\/crossmark-policy","source":"Crossref","is-referenced-by-count":15,"title":["Surgical correction of a rotational deformity of the shoulder in patients with obstetric brachial plexus palsy"],"prefix":"10.1302","volume":"95-B","author":[{"given":"T.","family":"Hultgren","sequence":"first","affiliation":[{"name":"Karolinska Institute, Department\rof Clinical Science and Education, S\u00f6dersjukhuset, Section\rfor Hand Surgery, S-118 83 Stockholm, Sweden."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"J\u00f6nsson","sequence":"additional","affiliation":[{"name":"Karolinska Institute, Department\rof Clinical Science and Education, S\u00f6dersjukhuset, Section\rfor Hand Surgery, S-118 83 Stockholm, Sweden."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Pettersson","sequence":"additional","affiliation":[{"name":"Karolinska Institute, Department\rof Clinical Science and Education, S\u00f6dersjukhuset, S-118\r83 Stockholm, Sweden."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Hammarberg","sequence":"additional","affiliation":[{"name":"Karolinska Institute, Department\rof Clinical Science and Education, S\u00f6dersjukhuset, Section\rfor Hand Surgery, S-118 83 Stockholm, Sweden."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"42","reference":[{"key":"r1","first-page":"1217","volume":"3","author":"Fairbank HAT","year":"1913","journal-title":"Lancet"},{"key":"r2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-190507000-00008"},{"key":"r3","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1302\/0301-620X.78B6.0780986","volume":"78","author":"Birch R","year":"1996","journal-title":"J Bone Joint Surg [Br]"},{"key":"r4","unstructured":"Carlioz H, Brahimi L. Place of internal disinsertion of the subscapularis muscle in the treatment of obstetric paralysis of the upper limb in children. Ann Chir Infant 1971;12:159\u2013167 (in French)."},{"key":"r5","first-page":"45","volume":"74","author":"Gilbert A","year":"1988","journal-title":"Rev Chir Orthop Reparatrice Appar Mot"},{"key":"r6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2009.11.026"},{"key":"r7","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-197860050-00019"},{"key":"r8","first-page":"357","volume":"39","author":"L\u2019Episcopo JB","year":"1939","journal-title":"N Y State J Med"},{"key":"r9","first-page":"564","volume":"88","author":"Pearl ML","year":"2006","journal-title":"J Bone Joint Surg [Am]"},{"key":"r10","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1925.02670240014005"},{"key":"r11","first-page":"218","volume":"13","author":"van der Sluijs JA","year":"2004","journal-title":"J Pediatr Orthop B"},{"key":"r12","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1016\/S0030-5898(20)31399-7","volume":"12","author":"Zancolli EA","year":"1981","journal-title":"Orthop Clin North Am"},{"key":"r13","doi-asserted-by":"publisher","DOI":"10.1097\/01.blo.0000138957.11939.70"},{"key":"r14","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200404000-00018"},{"key":"r15","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.88B2.17185"},{"key":"r16","doi-asserted-by":"publisher","DOI":"10.1177\/1753193412440221"},{"key":"r17","unstructured":"Mallet J. Obstetrical paralysis of the brachial plexus. II. Therapeutics. Treatment of sequelae. Priority for the treatment of the shoulder. Method for the expression of results. Rev Chir Orthop Reparatrice Appar Mot 1972;58(Suppl):166\u2013168 (in French)."},{"key":"r18","unstructured":"Birch R, Bonney G, Wynn Parry CB. Surgical disorders of the peripheral nerves. Churchill Livingstone: Edinburgh, 1987."},{"key":"r19","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.61.3.310"},{"key":"r20","doi-asserted-by":"publisher","DOI":"10.1177\/1753193408090764"},{"key":"r21","doi-asserted-by":"publisher","DOI":"10.1177\/1753193409349153"},{"key":"r22","doi-asserted-by":"publisher","DOI":"10.1002\/jor.22061"},{"key":"r23","unstructured":"Narakas AO. Obstetric brachial plexus injuries. In: Lamb DW, ed. The paralysed hand. Edinburgh: Churchill Livingstone, 1987."},{"key":"r24","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.93B1.25051"},{"key":"r25","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.K.01256"}],"container-title":["The Bone &amp; Joint Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/online.boneandjoint.org.uk\/doi\/pdf\/10.1302\/0301-620X.95B10.32049","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/online.boneandjoint.org.uk\/doi\/full-xml\/10.1302\/0301-620X.95B10.32049","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/online.boneandjoint.org.uk\/doi\/pdf\/10.1302\/0301-620X.95B10.32049","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,19]],"date-time":"2021-10-19T01:23:35Z","timestamp":1634606615000},"score":1,"resource":{"primary":{"URL":"https:\/\/online.boneandjoint.org.uk\/doi\/10.1302\/0301-620X.95B10.32049"}},"subtitle":["Short-term results in 270 patients"],"short-title":[],"issued":{"date-parts":[[2013,10]]},"references-count":25,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2013,10]]}},"alternative-id":["10.1302\/0301-620X.95B10.32049"],"URL":"https:\/\/doi.org\/10.1302\/0301-620x.95b10.32049","relation":{},"ISSN":["2049-4394","2049-4408"],"issn-type":[{"value":"2049-4394","type":"print"},{"value":"2049-4408","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,10]]},"assertion":[{"value":"2013-03-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2013-06-20","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2013-10-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}