Domzalski Marcin, Inan Muharrem, Littleton Aaron G, Miller Freeman
Department of Orthopedics, Alfred I. duPont Hospital for Children, Wilmington, DE 19899, USA.
J Pediatr Orthop. 2007 Jun;27(4):457-61. doi: 10.1097/01.bpb.0000271320.10869.d1.
The aim of our study was to evaluate the surgical results after pectoralis major muscle release in children with cerebral palsy and to assess a caregiver's satisfaction in patient's care after this procedure.Twenty-one shoulders in 13 patients were analyzed at least 12 months after surgery. All but 1 patient involved in our study had quadriplegic type of cerebral palsy involvement. In 17 limbs, only pectoralis release was performed; in 4 limbs, latissimus dorsi release was added. After clinical examination, a questionnaire was used to determine the caregiver's assessment. The passive range of abduction and flexion was maintained at an angle greater than 90 degrees in 10 patients. External rotation was restricted in 6 patients. All caregivers would recommend this surgery to another patient. All but one reported improvement in care of the patients after surgery. The indication for this surgical procedure is limited only to the selected cerebral palsy cases in which custodial care is impaired by shoulder adduction contracture. The 2 main indications for the procedure are the limitations in the ability to bathe the axilla and the difficulty in dressing.
我们研究的目的是评估脑瘫患儿胸大肌松解术后的手术效果，并评估护理人员对该手术后患者护理的满意度。对13例患者的21个肩部在术后至少12个月进行了分析。参与我们研究的患者中，除1例之外均为四肢瘫型脑瘫。17个肢体仅进行了胸大肌松解；4个肢体加做了背阔肌松解。临床检查后，使用问卷来确定护理人员的评估结果。10例患者外展和屈曲的被动活动范围保持在大于90度的角度。6例患者外旋受限。所有护理人员都表示会向其他患者推荐该手术。除1人外，所有护理人员均报告术后患者护理有改善。该手术的适应证仅限于因肩部内收挛缩而影响监护护理的特定脑瘫病例。该手术的2个主要适应证是清洗腋窝能力受限和穿衣困难。
