PREPONDERANT ROLE OF PHYSIOTHERAPY IN THE PREVENTION AND TREATMENT OF GLENOHUMERAL DYSPLASIA IN PATIENTS WITH OBSTETRIC BRACHIAL PLEXUS PALSY

Abstract

 Secondary shoulder joint deformities are an important aspect of treating upper brachial plexus lesions in patients with obstetric brachial plexus palsy. These deformities are known as glenohumeral dysplasia and are thought to be caused by an imbalance between functional internal rotators and weak external rotators of the glenohumeral joint what leads to a posterior subluxation of the humeral head, retroversion of the glenoid and subsequent glenohumeral joint dysfunction. Decreased shoulder passive external rotation range of motion is one of the most frequently reported limitation but not the only one. Careful and systematic assessment of shoulder motion may lead to suspect incipient glenohumeral joint changes if any limitation occurs. Imaging studies such as magnetic resonance imaging and ultrasound confirm the diagnosis. Physiotherapy is important not only in the treatment of glenohumeral dysplasia, but also in its diagnosis and prevention. Stretching any contracture at the glenohumeral joint while stabilizing scapulothoracic joint will prevent or minimize glenohumeral dysplasia progression. Parents and caregivers must be trained given that success requires their collaboration at home by performing these exercises.
capulothoracic joint stabilization is crucial but can be tedious and difficult for parents. In these cases, pediatric Kinesio taping of the scapulothoracic joint is a good option as it allows glenohumeral joint passive movements without scapular winging