• 文献检索
  • 文档翻译
  • 深度研究
  • 学术资讯
  • Suppr Zotero 插件Zotero 插件
  • 邀请有礼
  • 套餐&价格
  • 历史记录
应用&插件
Suppr Zotero 插件Zotero 插件浏览器插件Mac 客户端Windows 客户端微信小程序
定价
高级版会员购买积分包购买API积分包
服务
文献检索文档翻译深度研究API 文档MCP 服务
关于我们
关于 Suppr公司介绍联系我们用户协议隐私条款
关注我们

Suppr 超能文献

核心技术专利：CN118964589B侵权必究
粤ICP备2023148730 号-1Suppr @ 2026

文献检索

告别复杂PubMed语法，用中文像聊天一样搜索，搜遍4000万医学文献。AI智能推荐，让科研检索更轻松。

立即免费搜索

文件翻译

保留排版，准确专业，支持PDF/Word/PPT等文件格式，支持 12+语言互译。

免费翻译文档

深度研究

AI帮你快速写综述，25分钟生成高质量综述，智能提取关键信息，辅助科研写作。

立即免费体验

完全性产瘫臂丛神经麻痹的肩部功能与解剖结构：三角肌倾斜手术后的长期改善情况

Shoulder function and anatomy in complete obstetric brachial plexus palsy: long-term improvement after triangle tilt surgery.

作者信息

Nath Rahul K, Karicherla Priyanka, Mahmooduddin Faiz

机构信息

Texas Nerve and Paralysis Institute, Houston, TX, USA.

出版信息

Childs Nerv Syst. 2010 Aug;26(8):1009-19. doi: 10.1007/s00381-010-1174-2. Epub 2010 May 16.

DOI:10.1007/s00381-010-1174-2
PMID:20473676
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2903705/
Abstract

PURPOSE

Untreated complete obstetric brachial plexus injury (COBPI) usually results in limited spontaneous recovery of shoulder function. Older methods used to treat COBPI have had questionable success, with very few studies being published. The purpose of the current study was to examine the results of triangle tilt surgery on shoulder function and development in COBPI individuals.

METHODS

This study was conducted as a retrospective chart review. Inclusion criteria were COBPI patients that had undergone the triangle tilt procedure from 2005 to 2009 and were between the ages of 9 months and 12 years. COBPI was defined as permanent injury to all five nerve roots (C5-T1), with significant degradation in development and function of the hand. Twenty-five patients with a mean age of 5 (0.75-12) years were followed up clinically for more than 2 years.

RESULTS

The triangle tilt procedure resulted in demonstrable clinical enhancements with appreciable improvements in shoulder function, glenoid version, and humeral head congruity. There was a significant increase in the overall Mallet score (2.4 points, p < 0.0001) following surgical correction in patients that were followed up for more than 2 years.

CONCLUSIONS

The results of this study demonstrate that COBPI patients who develop SHEAR and medial rotation contracture deformities can benefit from the triangle tilt surgery, which improves shoulder function and anatomy across a range of pediatric ages. Despite these patients presenting late for surgery in general (5 years), significant improvements were observed in their glenohumeral (GH) dysplasia and their ability to perform shoulder and arm movements following surgery.

摘要

目的

未经治疗的完全性产科臂丛神经损伤（COBPI）通常导致肩部功能的自发恢复有限。过去用于治疗COBPI的方法成功率存疑，相关研究发表极少。本研究的目的是探讨三角倾斜手术对COBPI患者肩部功能和发育的效果。

方法

本研究采用回顾性病历审查。纳入标准为2005年至2009年间接受三角倾斜手术、年龄在9个月至12岁之间的COBPI患者。COBPI定义为所有五个神经根（C5 - T1）的永久性损伤，手部发育和功能显著退化。25例平均年龄为5岁（0.75 - 12岁）的患者接受了超过2年的临床随访。

结果

三角倾斜手术带来了明显的临床改善，肩部功能、关节盂形态和肱骨头一致性均有显著提高。随访超过2年的患者术后整体槌状指评分显著增加（2.4分，p < 0.0001）。

结论

本研究结果表明，出现剪切和内旋挛缩畸形的COBPI患者可从三角倾斜手术中获益，该手术可改善各年龄段儿童的肩部功能和解剖结构。尽管这些患者通常手术较晚（5岁），但术后其盂肱关节（GH）发育不良以及肩部和手臂运动能力仍有显著改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7487/2903705/5023f78af376/381_2010_1174_Fig10_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7487/2903705/6f7df519b77e/381_2010_1174_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7487/2903705/fc266ff22ca3/381_2010_1174_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7487/2903705/5f8efdb80e23/381_2010_1174_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7487/2903705/53acdf5a30b6/381_2010_1174_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7487/2903705/7be1b999ffc6/381_2010_1174_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7487/2903705/e76e361a2c8b/381_2010_1174_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7487/2903705/2ecff4043f31/381_2010_1174_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7487/2903705/3d54b53a5df1/381_2010_1174_Fig8_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7487/2903705/9ef0490154af/381_2010_1174_Fig9_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7487/2903705/5023f78af376/381_2010_1174_Fig10_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7487/2903705/6f7df519b77e/381_2010_1174_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7487/2903705/fc266ff22ca3/381_2010_1174_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7487/2903705/5f8efdb80e23/381_2010_1174_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7487/2903705/53acdf5a30b6/381_2010_1174_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7487/2903705/7be1b999ffc6/381_2010_1174_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7487/2903705/e76e361a2c8b/381_2010_1174_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7487/2903705/2ecff4043f31/381_2010_1174_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7487/2903705/3d54b53a5df1/381_2010_1174_Fig8_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7487/2903705/9ef0490154af/381_2010_1174_Fig9_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7487/2903705/5023f78af376/381_2010_1174_Fig10_HTML.jpg

相似文献

1
Shoulder function and anatomy in complete obstetric brachial plexus palsy: long-term improvement after triangle tilt surgery.完全性产瘫臂丛神经麻痹的肩部功能与解剖结构：三角肌倾斜手术后的长期改善情况
Childs Nerv Syst. 2010 Aug;26(8):1009-19. doi: 10.1007/s00381-010-1174-2. Epub 2010 May 16.
2
Long-term outcomes of triangle tilt surgery for obstetric brachial plexus injury.产科臂丛神经损伤三角倾斜手术的长期疗效
Pediatr Surg Int. 2010 Apr;26(4):393-9. doi: 10.1007/s00383-010-2550-4. Epub 2010 Feb 4.
3
Triangle tilt surgery as salvage procedure for failed shoulder surgery in obstetric brachial plexus injury.三角肌倾斜手术作为产科臂丛神经损伤肩部手术失败后的挽救手术。
Pediatr Surg Int. 2010 Sep;26(9):913-8. doi: 10.1007/s00383-010-2673-7. Epub 2010 Jul 29.
4
Effect of tendon transfers and extra-articular soft-tissue balancing on glenohumeral development in brachial plexus birth palsy.肌腱转移和关节外软组织平衡对臂丛神经产瘫中盂肱关节发育的影响。
J Bone Joint Surg Am. 2005 Feb;87(2):320-5. doi: 10.2106/JBJS.C.01614.
5
Primary and secondary shoulder reconstruction in obstetric brachial plexus palsy.产瘫性臂丛神经麻痹的一期和二期肩部重建
Injury. 2008 Sep;39 Suppl 3:S5-14. doi: 10.1016/j.injury.2008.06.001. Epub 2008 Aug 5.
6
Glenohumeral abduction contracture in children with unresolved neonatal brachial plexus palsy.儿童未解决的新生儿臂丛神经麻痹的盂肱关节外展挛缩。
J Bone Joint Surg Am. 2015 Jan 21;97(2):112-8. doi: 10.2106/JBJS.N.00203.
7
Surgical correction of the medial rotation contracture in obstetric brachial plexus palsy.产瘫中内旋挛缩的手术矫正
J Bone Joint Surg Br. 2007 Dec;89(12):1638-44. doi: 10.1302/0301-620X.89B12.18757.
8
Arthroscopic release of shoulder contracture secondary to obstetric brachial plexus palsy: retrospective study of 18 children with an average follow-up of 4.5 years.关节镜下松解产伤性臂丛神经麻痹所致的肩关节挛缩：18 例患儿平均随访 4.5 年的回顾性研究。
Orthop Traumatol Surg Res. 2012 Oct;98(6):638-44. doi: 10.1016/j.otsr.2012.06.013. Epub 2012 Sep 14.
9
The early effects of tendon transfers and open capsulorrhaphy on glenohumeral deformity in brachial plexus birth palsy.肌腱转移和开放性关节囊缝合术对臂丛神经产瘫中盂肱关节畸形的早期影响。
J Bone Joint Surg Am. 2008 Oct;90(10):2171-9. doi: 10.2106/JBJS.G.01517.
10
Shoulder internal rotation contracture in brachial plexus birth injury: proximal or distal subscapularis release?肩胛带丛神经损伤所致肩关节内旋挛缩：近侧还是远侧肩胛下肌松解？
J Shoulder Elbow Surg. 2021 May;30(5):1117-1127. doi: 10.1016/j.jse.2020.08.001. Epub 2020 Aug 25.

引用本文的文献

1
Outcomes of Brachial Plexus Neurolysis in 40 Patients With Obstetric Brachial Plexus Injury.40例产瘫患者臂丛神经松解术的疗效
Eplasty. 2025 Jan 29;25:e4. eCollection 2025.
2
Automated Assessment of Upper Extremity Function with the Modified Mallet Score Using Single-Plane Smartphone Videos.使用单平面智能手机视频通过改良槌状指评分对上肢功能进行自动评估。
Sensors (Basel). 2025 Mar 6;25(5):1619. doi: 10.3390/s25051619.
3
Peripheral nerve injuries in the pediatric population: a review of the literature. Part I: traumatic nerve injuries.

本文引用的文献

1
Triangle tilt surgery in an older pediatric patient with obstetric brachial plexus injury.一名患有产瘫性臂丛神经损伤的大龄儿科患者的三角肌倾斜手术。
Eplasty. 2009 Jun 30;9:e26.
2
Complete obstetric brachial plexus palsy: surgical improvement to recover a functional hand.完全性产科臂丛神经麻痹：通过手术改善以恢复手部功能
J Child Orthop. 2009 Apr;3(2):101-8. doi: 10.1007/s11832-009-0161-1. Epub 2009 Feb 19.
3
Arm rotated medially with supination - the ARMS variant: description of its surgical correction.手臂内旋伴旋后——ARMS变异型：其手术矫正的描述
儿科人群中的周围神经损伤：文献综述。第一部分：创伤性神经损伤。
Childs Nerv Syst. 2019 Jan;35(1):29-35. doi: 10.1007/s00381-018-3974-8. Epub 2018 Sep 13.
4
Restoration of Elbow Flexion in Patients With Complete Traumatic and Obstetric Brachial Plexus Injury After Functional Free Gracilis Muscle Transfer: Our Experience and Management.功能性游离股薄肌转移术后创伤性和产伤性臂丛神经完全损伤患者肘关节屈曲功能的恢复：我们的经验与处理
Eplasty. 2017 Nov 21;17:e34. eCollection 2017.
5
Subscapularis Z-lengthening in children with brachial plexus birth palsy loses efficiency at mid-term follow-up: a retrospective cohort study.儿童臂丛神经产瘫行肩胛下肌Z形延长术在中期随访时效果不佳：一项回顾性队列研究
Int Orthop. 2016 Apr;40(4):783-90. doi: 10.1007/s00264-015-3062-6. Epub 2015 Dec 9.
6
Kinesio arm taping as prophylaxis against the development of Erb's Engram.肌内效贴扎预防 Erb's 麻痹。
J Adv Res. 2013 Nov;4(6):485-91. doi: 10.1016/j.jare.2012.08.006. Epub 2012 Oct 1.
7
Extended long-term (5 years) outcomes of triangle tilt surgery in obstetric brachial plexus injury.产科臂丛神经损伤三角倾斜手术的长期（5年）扩展结局
Open Orthop J. 2013 Apr 29;7:94-8. doi: 10.2174/1874325001307010094. Print 2013.
8
Triangle tilt and steel osteotomy: similar approaches to common problems.三角倾斜和钢截骨术：解决常见问题的相似方法。
Open Orthop J. 2011 Mar 24;5:124-33. doi: 10.2174/1874325001105010124.
9
Comparing functional outcome of triangle tilt surgery performed before versus after two years of age.比较两岁之前与两岁之后进行的三角倾斜手术的功能结果。
Open Orthop J. 2011 Mar 16;5:59-62. doi: 10.2174/1874325001105010059.
BMC Musculoskelet Disord. 2009 Mar 16;10:32. doi: 10.1186/1471-2474-10-32.
4
Computed tomography of the shoulders in patients with obstetric brachial plexus injuries: a retrospective study.产瘫患者肩部的计算机断层扫描：一项回顾性研究。
Ann Surg Innov Res. 2008 Nov 7;2:4. doi: 10.1186/1750-1164-2-4.
5
Surgical correction of the medial rotation contracture in obstetric brachial plexus palsy.产瘫中内旋挛缩的手术矫正
J Bone Joint Surg Br. 2007 Dec;89(12):1638-44. doi: 10.1302/0301-620X.89B12.18757.
6
Improvement in abduction of the shoulder after reconstructive soft-tissue procedures in obstetric brachial plexus palsy.产科臂丛神经麻痹重建软组织手术后肩部外展功能的改善。
J Bone Joint Surg Br. 2007 May;89(5):620-6. doi: 10.1302/0301-620X.89B5.18403.
7
Scapular deformity in obstetric brachial plexus palsy: a new finding.产科臂丛神经麻痹中的肩胛畸形：一项新发现。
Surg Radiol Anat. 2007 Mar;29(2):133-40. doi: 10.1007/s00276-006-0173-1. Epub 2007 Jan 30.
8
Surgical correction of unsuccessful derotational humeral osteotomy in obstetric brachial plexus palsy: evidence of the significance of scapular deformity in the pathophysiology of the medial rotation contracture.产科臂丛神经麻痹中肱骨旋转截骨术失败后的手术矫正：肩胛畸形在旋内挛缩病理生理学中的重要性证据
J Brachial Plex Peripher Nerve Inj. 2006 Dec 27;1:9. doi: 10.1186/1749-7221-1-9.
9
The effect of derotational humeral osteotomy on global shoulder function in brachial plexus birth palsy.旋转肱骨截骨术对臂丛神经产瘫患者整体肩部功能的影响。
J Bone Joint Surg Am. 2006 May;88(5):1035-42. doi: 10.2106/JBJS.E.00680.
10
Arthroscopic release and latissimus dorsi transfer for shoulder internal rotation contractures and glenohumeral deformity secondary to brachial plexus birth palsy.关节镜下松解及背阔肌转移术治疗臂丛神经产瘫继发的肩部内旋挛缩和盂肱关节畸形。
J Bone Joint Surg Am. 2006 Mar;88(3):564-74. doi: 10.2106/JBJS.D.02872.