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Posterior dislocation of the humeral head in association with obstetric paralysis
Insights
Posterior humeral head dislocation in children with obstetric paralysis is treatable. Open reduction via an anterior approach offers a successful, single-stage solution with no redislocations observed.
Area of Science:
- Pediatric Orthopedics
- Pediatric Traumatology
- Obstetric Brachial Plexus Palsy
Background:
- Posterior dislocation of the humeral head is a rare complication associated with obstetric paralysis.
- Diagnosis can be challenging, often requiring advanced imaging techniques.
Purpose of the Study:
- To investigate the incidence and effective treatment of posterior humeral head dislocation in children with obstetric paralysis.
- To evaluate the outcomes of open reduction via an anterior approach for this condition.
Main Methods:
- Retrospective review of twelve pediatric patients diagnosed with posterior humeral head dislocation and obstetric paralysis.
- Diagnosis confirmed using computed tomography (CT) scans.
- Surgical treatment involved open reduction through an anterior approach, followed by immobilization in a shoulder spica and orthosis.
Main Results:
- All twelve patients underwent successful open reduction with no intraoperative complications.
- Postoperative CT scans confirmed satisfactory reduction in all cases.
- No redislocations occurred during a minimum follow-up period of twelve months.
Conclusions:
- Posterior humeral head dislocation in obstetric paralysis is more common than previously thought.
- Anterior open reduction is an effective and safe surgical treatment for this condition in pediatric patients.
- Prompt diagnosis and surgical intervention lead to favorable long-term outcomes without recurrence.
Abstract:
Twelve children with obstetric paralysis were diagnosed as having a posterior dislocation of the humeral head. The diagnosis was suspected on clinical grounds and confirmed by computed tomography (CT) scans in all cases. All 12 patients were treated with open reduction via an anterior approach. The age range at the time of surgery was from 7 months to 7 years (average, 2 years and 3 months). All patients were immobilized in a shoulder spica for 6 weeks and a further 6 weeks in an orthosis. All patients were examined by CT scans in the postoperative period, which confirmed a satisfactory reduction in all cases. With a minimal follow-up of 12 months, there have been no redislocations. This article demonstrates that dislocation of the shoulder in association with obstetric paralysis is not rare, as previously described, and shows that once diagnosed, the dislocation can be satisfactorily treated by a single anterior open reduction of the shoulder.