Case Report: Bionic Reconstruction in an Adult With Obstetric Brachial Plexus Injury.
Anna Boesendorfer, Agnes Sturma, Clemens Gstoettner and 3 others
PMID 36188841WHAT IT FOUND
One adult with lifelong severe obstetric brachial plexus injury reported better arm use after a package of surgery, prosthetic fitting, and rehabilitation.
Scores improved, but this is one person, not evidence that the approach works for others.
Key findings
01ARAT improved from 12 before surgery to 20 at 1.5 years, and SHAP improved from 8 to 29.
02DASH improved from 50 to 11.7, where 0 means no disability and 100 means complete dependence.
03The patient wore the prosthesis 5 to 6 hours per day on 4 to 5 days per week and said he would undergo the procedure again.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
This is one patient, so it cannot show what would happen in other adults with OBPI. The authors state that results from this one patient cannot be generalized. The patient had a severe Narakas IV injury and had already failed earlier reconstruction. The follow-up reported was 1.5 years. The outcome followed a package of surgery, prosthetic fitting, and rehabilitation, so no single component can be separated. The authors state that bionic reconstruction should be considered only after biological restoration and rehabilitation options have been exhausted.
Declared interests
The project received funding from the European Research Council under the European Union's Horizon 2020 Research and Innovation Program, Grant Agreement No. 810346. The authors declare that the research was conducted in the absence of commercial or financial relationships that could be construed as a potential conflict of interest.
The easy way to misread this
Do not conclude that any single part of this package works. The patient had surgery, prosthetic fitting, and rehabilitation together, and the authors state results cannot be generalized.