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青少年肩膀重建技巧在手臂出生伤害的肩膀重建技术

Joey S Kurtzman¹, Nathan Khabyeh-Hasbani², Ann Marie Feretti²

¹Plastic and Reconstructive Surgery, Wake Forest School Medicine, Winston Salem, NC, USA.

Journal of shoulder and elbow surgery

|September 6, 2024

概括

本研究介绍了一种手术技术和康复方案,以恢复未经治疗的臂出生损伤 (BPBI) 的青少年的肩膀功能. 这种方法显著改善了外部旋转,绑架和向前曲,提高了生活质量.

科学领域:

整形外科手术整形外科手术
儿科重建性手术儿科重建性手术
腕出生损伤 (BPBI) 的管理

背景情况:

臂出生损伤 (BPBI) 影响8%-36%的患者,往往导致肩部功能永久性损伤,特别是外部旋转和头部伸展.
青少年未经治疗的BPBI通常会导致有限的活跃和被动的外部旋转,以及由于诸如膜关节发育不良等因素而导致的上方肩膀功能减弱.
这项研究解决了对未获得及时或充分BPBI护理的青少年进行有效干预的需要.

研究的目的:

描述一个全面的手术技术,在未经治疗的BPBI的青少年肩部复苏.
概述一个术后康复方案,旨在优化功能恢复.
在一系列患者中评估这种综合方法的功能结果.

主要方法:

一个多阶段的手术复苏,涉及前部软组织释放,潜在的关节关节重建 (心脏切除术,关节骨切除术, subscapularis 滑动) 和骨造形术.
肌肉转移包括双极斜背脊 (latissimus dorsi) 进行绑架/向前曲,大腿骨 (teres major) 进行康复,大腿骨 (levator scapulae) 转移至脊柱上方 (supraspinatus) 进行绑架启动,尾骨 (lower trapezius) 进行外部旋转.
动态的头巾稳定通过形进步和逆侧下形转移,随后是严格的术后康复计划.

主要成果:

8名青少年患者 (平均年龄13.8岁),平均随访时间为35周,在手术和康复后表现出显著的功能改善.
手术后的外侧旋转从中性的0°到71°的手术前平均水平改善到中性和最大绑架的82°.
肩部绑架从手术前的0°-20°增加到手术后的平均115°,前向曲从0°-20°改善到平均91°.

结论:

描述的手术技术与结构化康复方案相结合,有效地恢复了腺关节的一致性,并恢复了肩膀结构,以改善绑架,向前曲和外部旋转.
这种方法为青少年患有治疗不足或未治疗的BPBI患者提供了显著的功能收益和改善生活质量.
虽然早期干预是首选的,但这种技术为改善长期BPBI缺陷的老年患者的功能提供了可行的解决方案.

关键词:

青少年是一个青少年.臂状交叉 (Brachial Plexus) 是一个神经系统.臂状交叉带出生损伤的伤害膜关节发育不良症膜关节发育不良症肩膀肩膀,肩膀肩膀,这是一个很好的方法.肩部复苏术是指肩部的复苏术.

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