Clinical and psychosocial outcomes following correction of supination deformity in obstetrical brachial plexus palsy patients: A retrospective study.

BACKGROUND: Forearm supination contracture is the mostAQ common deformity of the forearm following obstetric brachial plexus palsy (OBPP). Supination deformities in OBPP may be corrected by performing forearm osteotomy; however, the high recurrence rate limits patient satisfaction. Apart from the cosmetic impairment of this deformity, there are no previous reports on the clinical and psychosocial outcomes of forearm osteotomy in patients with supination deformities secondary to OBPP. Therefore, our study aimed to assess the clinical, functional, and psychosocial outcomes following forearm pronation osteotomy in OBPP patients with supination deformity. METHODS: This retrospective study was conducted after a chart review of all OBPP sequelae with supination forearm deformity in patients who underwent forearm pronating osteotomy from 2006 to 2018. Data relating to OBPP were gathered, and functional and psychosocial outcomes were assessed using the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire through interviews RESULTS: This study included 60 patients with a mean age of 8.7 years at the time of surgery. A total of 46 patients had lesions involving C5-T1 (76.7%). The mean preoperative supination deformity position was 68.5°, the mean amount of correction was 98.9°, and the mean forearm position was 30.5°, postoperatively. In the DASH assessment scale used postoperatively, 24 patients (42.9%) reported no restrictions on their daily activities, 25 patients (44.6%) believed that their social activities were unaffected, and 20 patients (35.7%) strongly disagreed with feeling less capable or less confident due to arm, shoulder, or hand problems. The factors significantly affecting position at the final follow-up were the amount of correction (p = 0.011), postoperative position (p = 0.005), and degree of pronation achieved (p = 0.02). The amount of correction significantly affected both self-confidence (p = 0.049) and activities of daily living (p = 0.033). CONCLUSION: In conclusion, our study showed that the position at the final follow-up, the degree of pronation achieved intraoperatively, and the postoperative position significantly affected the position at follow-up and the outcome assessment. The amount of intraoperative correction was significantly associated with higher self-confidence and normal activities of daily living.

Research activities and critical appraisal skills among Saudi orthopedic residents.

BACKGROUND: Medical research is a central part of any residency training. In view of the new Saudi orthopedic committee promotion regulation that mandates each resident to participate in a research project, the challenges that stand in the way of completion of substantial research within surgical residency must be investigated. The aim of this study was to assess the practice, attitudes, perception, and limitations associated with research among residents in the Saudi orthopedic program in the central region. METHODS: A cross-sectional study was conducted between June and July 2020 using an online-based survey. The total number of study participants was 128 orthopedic residents out of the 191 residents enrolled in the central region program. Data were analyzed, and descriptive statistics in the form of frequency and percentage were determined, analytical tests were performed with P < 0.05 being statistically significant. RESULTS: Most residents (95 %) participated in a research project during residency. Most projects (53.10 %) were case reports followed by retrospective studies (48.40 %). The majority (79.70 %) did not attend a research methods course during residency. Experience in research differed significantly (P < 0.05) by age, residency year, and center. The mean involvement score was significantly higher among males at 3 (± 1) than among females at 2 (± 0) (P < 0.001). Only 40.60 % have access to orthopedic journals, and the same percentage (40.60 %) knew how to Critique original articles. There was a statistically significant difference in the accessibility score according to the training center. Lack of faculty support and mentorship were the main barriers to medical research at 62.50 and 39.10 %, respectively. A total of 68.80 % reported that funding was not available through their institutes. CONCLUSIONS: In Saudi Arabia, the level of meaningful clinical research and publications by orthopedic residents is still low. The results of this study should be taken into consideration before the implementation of the new promotion criteria in the centers under the umbrella of Saudi orthopedic committee.

Characteristics and outcomes of obstetric brachial plexus palsy in a single Saudi center: an experience of ten years.

BACKGROUND: Obstetric brachial plexus palsy (OBPP) is considered a rare, unpredictable, and unavoidable injury of the upper limb. In this study, we presented a retrospective cohort study over a period of ten years in King Faisal Specialists Hospital and Research Centre (KFSH&RC), Riyadh, Saudi Arabia, to assess the characteristics and functional outcomes of OBPP. METHODS: Between January 2005 and December 2015, we carried out 125 repairs of OBPP in KFSH&RC. Out of 71 girls and 54 boys, two babies died of unrelated causes, so they were excluded from the review. All medical records of the patients who attended OBPP clinic at KFSH&RC were reviewed, and relative data were extracted. Descriptive measures for categorical variables and categorical variables were presented. Student's t test and Pearson's χ2 test were used. The level of statistical significance was set at P ≤ 0.05. RESULTS: A total of 123 patients were included in the study with a mean follow-up of 6.1 ± 2.4 years. Of those, 71 (57.7%) were females. Mean age at presentation was 4.2 ± 2.7 months with a birth weight of 3965.9 ± 629.6 g. More than half of the patients (56.1%) sustained the injury in the right side, and 62 patients (50.4%) were classified as Narakas I. Most of the surgeries (96.7%) were nerve grafting. Only 32 (26.0%) patients needed one or more secondary interventions. In the last visit, the mean total score of Mallet was 16.6 ± 2.8. Also, passive external rotation in adduction improved to 38.3 ± 14.5. Last Raimondi hand function grade was 2 ± 1. DISCUSSION: Our experience demonstrated the value of primary and secondary surgeries in patients with OBPP. Also, we presented the patterns of injury in Saudi patients presented to KFSH&RC.

Correction to: Characteristics and outcomes of obstetric brachial plexus palsy in a single Saudi centre: an experience of ten years.

The published online version contain mistake in article title. The correct title is "Characteristics and outcomes of obstetric brachial plexus palsy in a single Saudi centre: an experience of ten years".