Influence of Brachial Plexus Birth Injury Location on Glenohumeral Joint Morphology

Purpose Patient presentation after brachial plexus birth injury (BPBI) is influenced by nerve injury location; more contracture and bone deformity occur at the shoulder in postganglionic injuries. Although bone deformity after postganglionic injury is well-characterized, the extent of glenohumeral deformity after preganglionic BPBI is unclear. Methods Twenty Sprague-Dawley rat pups received preganglionic or postganglionic neurectomy on a single forelimb at postnatal days 3 to 4. Glenohumeral joints on affected and unaffected sides were analyzed using micro -computed tomography scans after death at 8 weeks after birth. Glenoid version, glenoid inclination, glenoid and humeral head radius of curvature, and humeral head thickness and width were measured bilaterally. Results The glenoid was significantly more declined in affected compared with unaffected shoulders after postganglionic (-17.7 degrees +/- 16.9 degrees) but not preganglionic injury. Compared with the preganglionic group, the affected shoulder in the postganglionic group exhibited significantly greater declination and increased glenoid radius of curvature. In contrast, the humeral head was only affected after preganglionic but not postganglionic injury, with a significantly smaller humeral head radius of curvature (-0.2 +/- 0.2 mm), thickness (-0.2 +/- 0.3 mm), and width (-0.3 +/- 0.4 mm) on the affected side compared with the unaffected side; changes in these metrics were significantly associated with each other. Conclusions These findings suggest that glenoid deformities occur after postganglionic BPBI but not after preganglionic BPBI, whereas the humeral head is smaller after preganglionic injury, possibly suggesting an overall decreased biological growth rate in this group. Clinical relevance This study expands understanding of the altered glenoid and humeral head morphologies after preganglionic BPBI and its comparisons with morphologies after post ganglionic BPBI. Copyright (C) 2021 by the American Society for Surgery of the Hand. All rights reserved.

Automated summary

The study found that glenoid deformities occur after postganglionic BPBI but not after preganglionic BPBI, while the humeral head is smaller after preganglionic injury. These results help to expand understanding of the altered glenoid and humeral head morphologies in both situations.