Improvements after mod Quad and triangle tilt revision surgical procedures in obstetric brachial plexus palsy

Table 1 Comparing functional improvements of other surgeon’s surgeries to mod Quad and/or triangle tilt in obstetric brachial plexus palsy

Patients	Other surgeons’ surgery	Gender	Age (yr)	Nerve involved	TT/MQ	Total Mallet pre- revision surgery	Total Mallet post- revision surgery
1	Botox	F	2.5	C5-C7	TT	13	23
2	Partial MQ, subscap release lat dorsi rerouting	M	6.4	C5-C7	TT	11	16
3	Neurolysis/nerve graft	F	4.2	Total	TT and MQ	13	18
4	Humeral osteotomy	F	11.1	C5-C7	TT and MQ	11	15
5	Neuroma excision, nervegraft	M	11.8	Total	TT	11	14
6	Nerve graft, HO, botox	F	7.1	Total	TT	11	17
7	Coracoacromial release/coracoid resection	M	5.5	C5-C7	TT	14	21
8	Botox	M	11.3	C5-C7	TT and MQ	10	15
9	Sural nerve graft	F	5.0	Total	TT	10	17
10	Botox	M	3.5	C5-C6	TT and MQ	12	20
11	Botox	M	4.3	Total	TT and MQ	12	18
12	Neurolysis	F	2.0	C5-C6	TT and MQ	11	17
13	Capsule release	F	8.5	Total	TT and MQ	13	19
14	Tendon transfer, neurolysis	M	4.3	C5-C8	TT and MQ	14	20
15	Neurolysis and botox	F	5.0	C5-C6	TT	13	20
16	Muscle transfer	M	7.9	C5-C7	TT	14	21
17	BP exploration	M	2.0	C5-C6	TT and MQ	15	20
18	Steindler flexorplasty	F	10.0	C5-C7	TT and MQ	13	18
19	Humeral osteotomy	M	14.0	C5-C6	MQ	12	18
20	Tendon transfer	F	3.0	C5-C7	MQ	14	20
	Mean ± STD		6.5			12 ± 1.5	18 ± 2.3
	P value					< 0.0001

MQ: Mod Quad; HO: Humeral osteotomy.

Table 2 Comparing anatomical improvements of triangle tilt to other surgeon surgeries in obstetric brachial plexus palsy

Patients	Other surgeons and previous surgeries	PreTT-PHHA	PostTT-PHHA	PreTT-Version	PostTT-Version	PreTT-SHEAR	PostTT-SHEAR
1	Subscap release and lat dorsi rerouting	8	33	-47	-14
2	Neurolysis, MQ, HO	16	14	-41	-35	24	10
3	MQ	-12	19	-65	-33	40	39
4	Nerve graft, FO, BTL, MQ	32	37	-21	-10	3	1
5	Botox, MQ	33	45	-18	-15	15	3
6	Nerve graft	47	48	-10	-1	5	14
7	Neurolysis, nerve graft	-7	22	-62	-12	8	22
8	Neuroma excision, nerve graft	34	35	-20	-11	0	0
9	Nerve transfer	33	29	-16	-21	15	12
10	Coracoacromial release/resection	-12	17	-51	-35	30	15
11	Neurolysis, nerve graft	13	4	-20	-15	7	4
12	Wrist Caps, HO	39	50	0	0	9	0
13	Sural nerve graft	38	51	-10	-4	0	1
14	Botox, MQ	-8	44	-38	-22	11	2
15	Neurolysis, MQ	-14	35	-33	-10	25	30
16	Muscle release	0	19	-45	-27	32	8
17	Anterior capsule release	-11	34	-53	-22	48	41
18	Tendon transfer and neurolysis	33	39	-18	-7	1	1
Mean		14.6 ±	31.9 ±	-31.6 ±	-16.3 ±	16.1 ±	11.9 ±
STD		21.7	13.6	19.3	11.0	14.7	13.5
P value			0.001		0.0002		0.087

Normal values are PHHA 50, glenoid version and SHEAR 0. TT: Triangle Tilt; MQ: Mod Quad; HO: Humeral Osteotomy; FO: Forearm Osteotomy; BTL: Biceps Tendon Lengthening; PHHA: Percentage of the Humeral Head Anterior.