Bishop Julie Y, Flatow Evan L
Mount Sinai School of Medicine, Department of Orthopaedic Surgery, New York, NY 10029-6574, USA.
Clin Orthop Relat Res. 2005 Mar(432):41-8. doi: 10.1097/01.blo.0000156005.01503.43<.
Pediatric shoulder trauma is relatively uncommon. Injuries requiring surgical intervention are even rarer. However, it is important for the practicing orthopaedic surgeon to differentiate nonoperative injuries from the urgent and potentially operative injuries. Missing such an injury in the pediatric population could be potentially life threatening or lead to long-term disability. Posterior sternoclavicular dislocations should be differentiated from medial clavicular physeal injuries and promptly reduced. Open fractures or neurovascular threatening fractures should be attended to immediately. Severely displaced proximal physeal humerus fractures in the older child often have a better long-term outcome after anatomic reduction. Finally, although glenohumeral dislocations, once reduced, are not life threatening or limb threatening, they do have a very high incidence of recurrence in adolescent patients. This should be kept in mind when formulating the treatment plan. If these overall treatment recommendations and plans are adhered to, the majority of pediatric shoulder trauma will result in a good outcome.
小儿肩部创伤相对少见。需要手术干预的损伤更为罕见。然而,对于执业骨科医生来说,区分非手术损伤与紧急且可能需要手术的损伤很重要。在小儿群体中漏诊此类损伤可能会危及生命或导致长期残疾。后胸锁关节脱位应与锁骨内侧骨骺损伤相鉴别并及时复位。开放性骨折或威胁神经血管的骨折应立即处理。年龄较大儿童的严重移位的肱骨近端骨骺骨折,解剖复位后通常有较好的长期预后。最后,虽然肩关节脱位一旦复位,不会危及生命或肢体,但在青少年患者中复发率非常高。制定治疗计划时应牢记这一点。如果遵循这些总体治疗建议和计划,大多数小儿肩部创伤将取得良好的治疗效果。