Bae Donald S, Waters Peter M
Department of Orthopaedic Surgery, Children's Hospital, Boston, MA 02115, USA.
Tech Hand Up Extrem Surg. 2007 Mar;11(1):8-14. doi: 10.1097/01.bth.0000248359.14448.e6.
In patients with brachial plexus birth palsy, persistent muscular imbalance across the developing shoulder results in progressive glenohumeral dysplasia, characterized by increased glenoid retroversion, humeral head flattening, and posterior subluxation of the humeral head. Soft-tissue procedures-such as tendon transfers and musculotendinous lengthenings--will provide limited functional improvements in the setting of advanced glenohumeral deformity. For patients with internal rotation contracture and external rotation weakness associated with severe glenohumeral dysplasia, external rotation osteotomy of the humerus may be used to improve global shoulder function. The purpose of this article is to review the history, indications, and surgical technique of external rotation humeral osteotomy for patients with brachial plexus birth palsy.
在臂丛神经产瘫患者中，发育中的肩部持续存在肌肉失衡会导致进行性的盂肱关节发育不良，其特征为关节盂后倾增加、肱骨头扁平以及肱骨头向后半脱位。在晚期盂肱关节畸形的情况下，诸如肌腱转移和肌腱延长等软组织手术只能带来有限的功能改善。对于伴有严重盂肱关节发育不良的内旋挛缩和外旋无力的患者，肱骨外旋截骨术可用于改善整体肩部功能。本文旨在回顾臂丛神经产瘫患者肱骨外旋截骨术的历史、适应症和手术技术。
