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[新生儿肩关节脱位。12例报告及文献复习]

[Shoulder dislocation in the newborn. Report of 12 cases and review of the literature].

作者信息

Schmelzer-Schmied N, Ochs B G, Carstens C

机构信息

Sektion für Kinderorthopädie und Wirbelsäulenchirurgie, Orthopädische Klinik, Universität, Heidelberg.

出版信息

Orthopade. 2005 May;34(5):454-61. doi: 10.1007/s00132-005-0775-z.

Abstract

Shoulder dislocation in the newborn is a rare entity. Therefore, a therapeutic regimen does not exist. This retrospective clinical study (1967-2003) includes 9 newborns with 12 dislocations of the shoulder. The data focus in particular on the therapeutic strategy and its success. The position of the joint and its functionality were monitored with a questionnaire. Publications from 1904 to 2003 were reviewed and served for comparison. Results of calculations showed that 0.018-0.07% of newborns suffer from shoulder dislocations. The diagnosis was made on average at the age of 22 days. Our data include four cases each of congenital and paralytic and two cases each of spastic and traumatic shoulder dislocations. All of them were initially treated conservatively, but because of inadequate results one patient finally had to be operated. In the follow-up of 19.4 years, none of them developed a redislocation and all shoulder functions were suitable for daily life. We propose that patients primarily be treated conservatively; however, if therapy fails, surgery has to be performed.

摘要

新生儿肩关节脱位是一种罕见的病症。因此,目前尚无治疗方案。这项回顾性临床研究(1967年至2003年)纳入了9例新生儿的12次肩关节脱位。数据特别关注治疗策略及其成效。通过问卷调查对关节位置及其功能进行监测。查阅了1904年至2003年的相关文献以供比较。计算结果显示,0.018%至0.07%的新生儿患有肩关节脱位。平均诊断年龄为22天。我们的数据包括先天性和麻痹性肩关节脱位各4例,痉挛性和创伤性肩关节脱位各2例。所有患者最初均接受保守治疗,但由于效果不佳,有1例患者最终不得不接受手术。在19.4年的随访中,无一例出现再次脱位,所有肩关节功能均适合日常生活。我们建议,患者首先应接受保守治疗;然而,如果治疗失败,则必须进行手术。

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