{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,4,5]],"date-time":"2022-04-05T23:00:23Z","timestamp":1649199623961},"reference-count":12,"publisher":"Bentham Science Publishers Ltd.","issue":"1","license":[{"start":{"date-parts":[[2011,3,16]],"date-time":"2011-03-16T00:00:00Z","timestamp":1300233600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"content-domain":{"domain":["openorthopaedicsjournal.com","benthamopen.com"],"crossmark-restriction":true},"short-container-title":["TOORTHJ"],"published-print":{"date-parts":[[2011,3,16]]},"abstract":"\n Background:<\/jats:title>\n Many patients each year who are born with obstetric brachial plexus injuries eventually do not achieve complete recovery. As a result of the primary nerve injuries, these patients will often develop bony deformities involving the shoulder joint as a secondary consequence. The triangle tilt surgery has been shown to be an effective procedure to correct these deformities and has been performed on patients ranging in age from less than a year old to adolescence. The purpose of this retrospective study is to compare outcomes of triangle tilt surgery performed on patients before the age of 2 years versus after 2 years of age to determine an optimal age to operate on these children.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n 36 patients with deformities developed secondarily from the initial obstetric brachial plexus injury in this study were divided into 2 groups. Group 1, those who had undergone triangle tilt surgery at < 2 yrs of age (16 patients). Group 2, those who were operated at > 2 yrs of age (20 patients). Group 1 age range: 9 months to 23 months, average: 18 months. Group 2 age range: 26 months to 9 years, average: 6 years.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n Significant differences were found between the 2 groups (0-2 yrs vs<\/jats:italic> > 2yrs) in regards to overall changes (pre- to post-op) in Mallet score, external rotation score, hand-to-mouth score, and supination angle.<\/jats:p>\n <\/jats:sec>\n \n Discussion:<\/jats:title>\n This study demonstrates that triangle tilt surgery had better outcomes on clinical functioning if performed before the age of 2 years, however, improvement in clinical functioning can still be achieved if the triangle tilt surgery is performed after the age of 2 years as well. A possible mechanism to explain this phenomenon is the increased potential for anatomical remodeling if the triangle tilt surgery is performed at a younger age, thereby leading to significant functional improvement.<\/jats:p>\n <\/jats:sec>","DOI":"10.2174\/1874325001105010059","type":"journal-article","created":{"date-parts":[[2011,3,30]],"date-time":"2011-03-30T05:50:26Z","timestamp":1301464226000},"page":"59-62","update-policy":"http:\/\/dx.doi.org\/10.2174\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Comparing Functional Outcome of Triangle Tilt Surgery Performed Before Versus After Two Years of Age"],"prefix":"10.2174","volume":"5","author":[{"given":"Rahul K","family":"Nath","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chandra","family":"Somasundaram","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Faiz","family":"Mahmooduddin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"965","reference":[{"key":"refR1","unstructured":"Birch R. \n \n Late sequelae at the shoulder in obstetrical palsy in children In: Randelli M, Karlsson J, Eds. \n Surgical techniques in orthopaedics and traumatology: Shoulder. \n Paris: Elsevier 2001; 55.\n \n \n \n 55-200-E-210"},{"key":"refR2","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1302\/0301-620X.83B4.11205","volume":"83","author":"van der Sluijs JA","year":"2001","unstructured":"van der Sluijs JA, van Ouwerkerk WJ, de Gast A, Wuisman PI, Nollet F, Manoliu RA. \n Deformities of the shoulder in infants younger than 12 months with an obstetric lesion of the brachial plexus \n J Bone Joint Surg (Br) \n 2001; \n 83\n : 551-.","journal-title":"J Bone Joint Surg (Br)"},{"key":"refR3","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1148\/radiol.2313021057","volume":"231","author":"Kon DS","year":"2004","unstructured":"Kon DS, Darakjian AB, Pearl ML, Kosco AE. \n Glenohumeral deformity in children with internal rotation contractures secondary to brachial plexus birth palsy: intraoperative arthrographic classification \n Radiology \n 2004; \n 231\n : 791-5.","journal-title":"Radiology"},{"key":"refR4","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1302\/0301-620X.89B5.18403","volume":"89","author":"Nath RK","year":"2007","unstructured":"Nath RK, Paizi M. \n Improvement in abduction of the shoulder after reconstructive soft-tissue procedures in obstetric brachial plexus palsy \n J Bone Joint Surg Br \n 2007; \n 89\n : 620-26.","journal-title":"J Bone Joint Surg Br"},{"key":"refR5","first-page":"e26","volume":"9","author":"Nath RK","year":"2009","unstructured":"Nath RK, Amrani A, Melcher SE, Eichhorn MG. \n Triangle tilt surgery in an older pediatric patient with obstetric brachial plexus injury \n ePlasty \n 2009; \n 9\n : e26.","journal-title":"ePlasty"},{"key":"refR6","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1007\/s00381-010-1174-2","volume":"26","author":"Nath RK","year":"2010","unstructured":"Nath RK, Karicherla P, Mahmooduddin F. \n Shoulder function and anatomy in complete obstetric brachial plexus palsy: long-term mprovement after triangle tilt surgery \n Child's Nervous System \n 2010; \n 26\n : 1009-9.","journal-title":"Child's Nervous System"},{"key":"refR7","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1007\/s00383-010-2673-7","volume":"26","author":"Nath RK","year":"2010","unstructured":"Nath RK, Avila MB, Karicherla P. \n Triangle tilt surgery as salvage procedure for failed shoulder surgery in obstetric brachial plexus injury \n Pediatr Surg Int \n 2010; 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