在手臂中肩部功能重建出生损伤:前肩部释放和脊柱辅助器到上神经转移
Jayme A Bertelli1, Mohammed Tahir2
1Department of Plastic Surgery, Joana de Gusmão Children's Hospital, Florianópolis, Santa Catarina, Brazil; Department of Surgery, Federal University of Santa Catarina, Florianópolis, Brazil.
The Journal of hand surgery
|December 6, 2024
概括
脊柱辅助上神经转移与前肩部释放显著改善肩部外部旋转和绑架在儿童手臂出生损伤. 这种手术干预为恢复肩膀功能提供了一个有希望的解决方案.
科学领域:
- 整形外科手术 整形外科手术
- 儿科手术 儿科手术
- 神经外科 神经外科
背景情况:
- 臂出生损伤 (BPBI) 通常会导致肩膀内部旋转收缩和有限的绑架.
- 在BPBI患者中恢复肩膀功能对于上肢使用和整体生活质量至关重要.
研究的目的:
- 为了评估脊柱辅助神经转移与前肩部释放相结合的脊柱辅助神经转移的疗效.
- 评估在患有BPBI的儿科患者中恢复肩部外部旋转和绑架的情况.
主要方法:
- 一组41名患有BPBI的儿童接受了手术,包括前肩部释放和神经转移.
- 程序涉及 subscapularis 断层切除,囊切除,以及脊柱辅助器,以转移头骨上神经.
- 术后的移动范围被与手术前的状态进行了比较,平均31个月的随访时间.
主要成果:
- 分析了26名患者,手术时平均年龄为15个月.
- 观察到显著的改善:平均外部旋转从64°增加到116°,绑架从36°增加到94°.
- 大多数患者表现出功能改善,没有再次出现内部旋转合并; 一名患者没有恢复外部旋转.
结论:
- 脊柱辅助上神经转移,与下神经切割,有效地改善肩膀外部旋转和绑架在儿童BPBI.
- 神经转移的时间 (在6个月之前或之后) 并没有妨碍显著的功能收益.
- 这种手术方法是管理内部旋转收缩和改善儿科BPBI的肩部移动性的可行选择.
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