Correlation of Radiographic Muscle Cross-Sectional Area with Glenohumeral Deformity in Children with Brachial Plexus Birth Palsy
Notice bibliographique
Résumé
BACKGROUND: Muscle imbalance about the shoulder in children with persistent brachial plexus birth palsy is thought to contribute to glenohumeral joint deformity. We quantified cross-sectional areas of the internal and external rotator muscles in the shoulder by magnetic resonance imaging in patients with chronic brachial plexopathy and the correlation between these muscle cross-sectional area ratios and glenohumeral deformity. The purposes of this investigation were to evaluate differences in the ratios between affected and unaffected shoulders in the same individual and to assess whether an increased internal to external rotator muscle cross-sectional area correlated with greater glenohumeral deformity. METHODS: This cohort study consisted of magnetic resonance imaging of seventy-four patients with chronic neuropathic changes about the shoulder from brachial plexus birth palsy. There were at least nine patients with scans available for each of the five classified subtypes of glenohumeral deformity: type I (fifteen patients), type II (seventeen), type III (seventeen), type IV (sixteen), and type V (nine). Cross-sectional areas of the pectoralis major, teres minor-infraspinatus (external rotators), and subscapularis muscles were measured. The supraspinatus muscle cross-sectional area could not be reliably measured. The ratio of subscapularis to external rotators, the ratio of pectoralis major to external rotators, and the compound ratio of subscapularis and pectoralis major to external rotators were compared with the severity of the glenohumeral deformity. Passive range of motion, Mallet and Toronto clinical scores, and Narakas type were also compared with the severity of the glenohumeral deformity and the muscle cross-sectional area measurements. RESULTS: Muscle cross-sectional area ratios were significantly correlated with glenohumeral deformity type. The mean ratio of pectoralis major to external rotators for affected shoulders over all deformity types compared with that for unaffected shoulders was significantly increased by 30% (p < 0.001); the mean ratio for subscapularis and pectoralis major to external rotators, by 19% (p = 0.015), and the mean ratio for subscapularis to external rotators, by 10% (p = 0.008). There was a significant increase in the ratio of pectoralis major to external rotators in affected shoulders within each type of deformity. Analysis of variance indicated higher ratios of pectoralis major to external rotator muscle cross-sectional areas in more severe deformity types (p < 0.001). There were significant differences in external rotation measurements with the shoulder at 90 degrees of abduction only among glenohumeral deformity types I, II, and III (p < 0.05). CONCLUSIONS: The degree of muscle imbalance between internal and external rotators about the shoulder is measurable by magnetic resonance imaging in children with persistent brachial plexopathy, and the imbalance correlates with the degree of glenohumeral deformity. Our results may provide useful information to guide the timing and the choice of operative intervention in these children.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».