Zhang Zi-Ming, Zhang Jing, Lu Mei-Ling, Cao Gen-Lin, Dai Li-Yang
Department of Pediatric Orthopaedics, Xinhua Hospital, Shanghai, China.
Clin Orthop Relat Res. 2007 Apr;457:171-5. doi: 10.1097/BLO.0b013e31802db115.
We treated 26 patients with congenital elevation of the scapula by excising the superomedial part of the scapula. We also simultaneously resected the omovertebral bone when present. A modified inverted L-shape incision was used to release the contracted tissue around the medial edge of the scapula. We evaluated 28 shoulders (26 patients) at a minimum of 10 months followup (mean, 3.9 years; range, 10 months-7 years). The improvement rate for range of shoulder abduction was 59.11%. Eighteen shoulders with preoperative abduction less than 120 degrees achieved an average improvement of 52 degrees, whereas 10 shoulders with a preoperative abduction range greater than 120 degrees achieved an average improvement of 19 degrees. However, there was no difference in the improvement rate of the range of shoulder abduction between the two groups (60.94% versus 56%). Twenty-three shoulders (82.24%) attained various degrees of cosmetic improvement after the operation. There were no neurologic complications during or after surgery. No patients complained of scar problems. Excising the superomedial part of the scapula is a safe, simple operation for treating congenital elevation of the scapula.
我们通过切除肩胛骨的内上部分治疗了26例先天性高肩胛症患者。若存在肩胛提肌,我们也同时将其切除。采用改良倒L形切口松解肩胛骨内侧缘周围挛缩的组织。我们对28个肩部(26例患者)进行了评估,随访时间至少为10个月(平均3.9年;范围10个月至7年)。肩关节外展活动度的改善率为59.11%。术前外展小于120度的18个肩部平均改善了52度,而术前外展范围大于120度的10个肩部平均改善了19度。然而,两组之间肩关节外展活动度的改善率并无差异(60.94%对56%)。23个肩部(82.24%)术后获得了不同程度的外观改善。手术期间及术后均无神经并发症。没有患者抱怨瘢痕问题。切除肩胛骨的内上部分是治疗先天性高肩胛症的一种安全、简单的手术方法。