Al-Qattan M M
Division of Plastic Surgery, King Saud University, Riyadh, Saudi Arabia.
J Hand Surg Br. 2003 Oct;28(5):487-90. doi: 10.1016/s0266-7681(02)00393-5.
This report describes the results of latissimus dorsi transfer for weakness of shoulder external rotation in 12 children with obstetric brachial plexus palsy. Selection criteria for the muscle transfer procedure included good passive external rotation of the shoulder, normal skeletal development of the shoulder joint, and adequate power of the deltoid. In addition to measuring the ranges of motion of joints before and after surgery, a modified Mallet grading system was utilized for the functional assessment of shoulder external rotation. At a mean follow-up of 4 years, two of the 12 children had recurrence of the shoulder deformity. In the remaining 10 children, the mean active external rotation was 30 degrees (range, 20-60 degrees ), mean shoulder abduction was 140 degrees (range, 90-170 degrees ), and all children had achieved a modified Mallet score of 4.
本报告描述了12例产瘫性臂丛神经麻痹患儿行背阔肌转移术治疗肩外旋无力的结果。肌肉转移手术的选择标准包括肩部被动外旋良好、肩关节骨骼发育正常以及三角肌力量充足。除了测量手术前后关节的活动范围外，还采用改良的马利特分级系统对肩外旋功能进行评估。平均随访4年时，12例患儿中有2例出现肩部畸形复发。其余10例患儿的平均主动外旋为30度（范围为20 - 60度），平均肩外展为140度（范围为90 - 170度），所有患儿的改良马利特评分均达到4分。
