早期的肘部曲收缩预测了手臂带婴儿的肩膀收缩出生伤害
David S Liu1, Patricia Miller1, Anna Rothenberg1
1Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, MA.
The Journal of pediatrics
|September 17, 2023
概括
由于臂出生损伤 (BPBI) 导致肘部曲收缩症 (EFC) 的儿童面临更高的肩部收缩和手术风险. 对EFC的早期查可以帮助识别有风险的婴儿,以便及时评估和干预.
科学领域:
- 儿科整形外科 儿科整形外科
- 新生儿护理 新生儿护理
- 康复医学 康复医学 康复医学
背景情况:
- 腕出生损伤 (BPBI) 可以导致婴儿的上肢功能障碍显著.
- 肘部曲收缩 (EFC) 是一种常见的并发症,但其与肩膀问题的关联尚未完全理解.
- 早期发现二次并发症对于患有BPBI的婴儿的最佳结果至关重要.
研究的目的:
- 为了研究肘部曲收缩 (EFC) 和肩部收缩在患有臂出生损伤 (BPBI) 的婴儿的发展之间的关系.
- 确定EFC是否是增加手术干预肩部并发症可能性的预测因素.
- 评估EFC作为一种潜在的查工具,用于识别需要专业BPBI护理的婴儿.
主要方法:
- 在1993年至2020年期间被诊断患有BPBI的儿科患者的回顾性评估.
- 纳入标准:2岁以下的儿童患有BPBI和肘曲收缩 ≥10°.
- 匹配的队列分析比较了有和没有EFC的患者,评估了运动范围,合发育和手术结果.
主要成果:
- 与对照组相比,患有EFC的患者肩部运动范围显著减少 (12°更少).
- 存在EFC与发展肩缩的几率增加了2.5倍.
- 每增加5度的EFC与增加50%的肩膀缩的几率以及增加62%的需要肩膀手术的几率相关.
结论:
- 肘部曲收缩 (EFC) 作为一种有价值的查工具,用于识别手臂出生损伤 (BPBI) 的婴儿的肩部收缩,这可能很难直接评估.
- 对于患有EFC的婴儿,建议立即转诊到BPBI专科诊所,以防止肩膀收缩的进展,并可能避免更复杂的外科手术.
- 早期发现和管理EFC可以减轻二次肩部并发症的风险在儿科BPBI人口.
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