Nath R K, Lyons A B, Melcher S E, Paizi M
Texas Nerve and Paralysis Institute, 2201 W. Holcombe Boulevard, Houston, Texas 77030, USA.
J Bone Joint Surg Br. 2007 Dec;89(12):1638-44. doi: 10.1302/0301-620X.89B12.18757.
The medial rotation contracture caused by weak external rotation secondary to obstetric brachial plexus injury leads to deformation of the bones of the shoulder. Scapular hypoplasia, elevation and rotation deformity are accompanied by progressive dislocation of the humeral head. Between February and August 2005, 44 children underwent a new surgical procedure called the 'triangle tilt' operation to correct this bony shoulder deformity. Surgical levelling of the distal acromioclavicular triangle combined with tightening of the posterior glenohumeral capsule (capsulorrhaphy) improved shoulder function and corrected the glenohumeral axis in these patients. The posture of the arm at rest was improved and active external rotation increased by a mean of 53 degrees (0 degrees to 115 degrees ) in the 40 children who were followed up for more than one year. There was a mean improvement of 4.9 points (1.7 to 8.3) of the Mallet shoulder function score after surgical correction of the bony deformity.
产科臂丛神经损伤继发外旋无力导致的内旋挛缩会引起肩部骨骼变形。肩胛发育不全、抬高和旋转畸形伴有肱骨头的进行性脱位。2005年2月至8月期间，44名儿童接受了一种名为“三角倾斜”手术的新手术，以纠正这种肩部骨骼畸形。远端肩锁三角的手术平整结合后盂肱关节囊收紧（关节囊缝合术）改善了这些患者的肩部功能并纠正了盂肱关节轴。在随访一年以上的40名儿童中，休息时手臂的姿势得到改善，主动外旋平均增加了53度（从0度到115度）。骨骼畸形手术矫正后，槌状肩功能评分平均提高了4.9分（从1.7分到8.3分）。
