ter Steeg A M, Hoeksma A F, Dijkstra P F, Nelissen R G H H, De Jong B A
Rehabilitation Centre Rijndam, Rotterdam, The Netherlands.
Disabil Rehabil. 2003 Jan 7;25(1):1-8.
Description of shoulder sequelae in obstetrical brachial plexus injury (OBPI) patients who had spontaneous functional recovery, in the context of historical and current conservative methods of treatment.
Case study of a baby with serious complications, followed by a review of the literature from 1900 until 2001 about conservative treatment of OBPI with respect to the prevention of shoulder complications.
Description of contractures and bony deformities did not show important discrepancies over time, other than more detailed images because of new technical possibilities. There is no agreement on the explanation of the development of these deformities. Secondary changes caused by muscular imbalance and longstanding contracture are recognized by all authors. A primary osteoarticular lesion was recognized as a possible cause in the beginning of the twentieth century, then forgotten for a long time and only in the 1980s had gained interest again. The main change in treatment concerns the use of arm braces. This was strongly recommended in the first half of the twentieth century, then advised against and is at this moment not anymore mentioned.
There is no consensus on the cause of contractures and bony deformities in children with OBPI. Conservative methods of treatment have changed over the years, without research on the outcome of these treatment changes.
在回顾历史和当前保守治疗方法的背景下，描述产科臂丛神经损伤（OBPI）患者自发功能恢复后的肩部后遗症。
对一名有严重并发症的婴儿进行病例研究，随后回顾1900年至2001年期间关于OBPI保守治疗以预防肩部并发症的文献。
除了因新技术可能性而有更详细的图像外，挛缩和骨畸形的描述随时间推移并未显示出重大差异。对于这些畸形的发生原因尚无定论。所有作者都认识到肌肉失衡和长期挛缩引起的继发性改变。二十世纪初，原发性骨关节病变被认为是一个可能的原因，随后很长一段时间被遗忘，直到20世纪80年代才再次引起关注。治疗方面的主要变化涉及臂托的使用。在二十世纪上半叶强烈推荐使用，随后又不建议使用，目前已不再提及。
对于OBPI患儿挛缩和骨畸形的原因尚无共识。多年来保守治疗方法有所改变，但未对这些治疗变化的结果进行研究。
