在残留手臂内肩部内转收缩的最小侵入性肩下部释放残留手臂出生损伤
Maulin Shah1, Shalin Shah1, Nischal Naik2
1Orthokids Clinic, Ahmedabad, India.
JBJS essential surgical techniques
|June 26, 2025
概括
最少侵入性 subscapularis 释放有效地治疗肩膀内部旋转收缩在腕出生伤害患者. 这种关节外手术改善了运动范围,并可能导致关节关节重塑.
科学领域:
- 整形外科手术 整形外科手术
- 儿科整形外科 儿科整形外科
- 重建性手术是一种重建性手术.
背景情况:
- 肩部内部旋转收缩是残留臂出生损伤 (BPBI) 的常见并发症.
- 最少侵入性骨下部释放 (MISR) 是一种额外关节技术,通过释放骨下部起源于肩来解决这种收缩.
- 这种手术,特别是联合肌转移,促进了腺关节的重塑.
研究的目的:
- 描述在BPBI中肩部内部旋转收缩症的微创性脑下垂体释放的技术和结果.
- 突出MISR中部边界方法的合理性和好处.
- 为了比较MISR与替代性外科干预.
主要方法:
- 该手术涉及在肩的中间边缘上做一个小切口.
- 周骨提升器用于从头骨下面释放 subscapularis 肌肉纤维.
- 温和的外部旋转拉伸了关节囊,随后应用了肩膀形.
主要成果:
- 观察到被动 (80°) 和主动 (43°) 外侧旋转以及肩部移动 (平均142°) 的显著改善.
- 手术后的马莱特分数从12.8提高到18.5.
- 在年轻的患者中,预计将进行膜体重塑;老年患者可能保留一些内部旋转姿势.
结论:
- 最少侵入性下肩膀释放是BPBI中肩膀内部旋转收缩症的有效治疗方法.
- 该技术保持了内部旋转强度,并比开放式或关节镜式方法具有优势.
- 在肩膀运动范围和功能得分方面,MISR带来了显著的收益.
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