Ruchelsman David E, Grossman John A I, Price Andrew E
NYU Hospital for Joint Diseases, NYU Langone Medical Center, New York, New York, USA.
Bull NYU Hosp Jt Dis. 2011;69(1):36-43.
Shoulder deformity remains the most common musculo-skeletal sequela following a brachial plexus birth injury. The natural history of untreated glenohumeral deformity is one of progression in this unique patient population. In infants and young children with persistent neurological deficits, shoulder dysfunction becomes a major source of morbidity, as these children have extreme difficulty placing the hand in space. The functional limitations due to muscle denervation and the resultant periarticular soft tissue contractures and progressive osseous deformities have been well-characterized. Increasing attention is being given to the glenohumeral dysplasia (GHD) and the associated prevalence of early posterior dislocation of the shoulder in infants with brachial plexus birth injuries. GHD represents a spectrum of findings, including glenoid and humeral head articular incongruities and dysplasia, subluxation, and frank dislocation. This article presents our comprehensive, temporally-based management strategies for the glenohumeral joint deformities in these children utilizing soft tissue and bony reconstructive procedures.
肩部畸形仍然是臂丛神经产伤后最常见的肌肉骨骼后遗症。在这一特殊患者群体中，未经治疗的盂肱关节畸形的自然病程是病情进展。在患有持续性神经功能缺损的婴幼儿中，肩部功能障碍成为发病的主要原因，因为这些儿童将手放置到空间中极为困难。由于肌肉失神经支配以及由此导致的关节周围软组织挛缩和进行性骨畸形所造成的功能限制已得到充分描述。臂丛神经产伤婴儿的盂肱发育不良（GHD）及相关的早期肩关节后脱位患病率越来越受到关注。GHD表现为一系列症状，包括肩胛盂和肱骨头关节不匹配及发育异常、半脱位和完全脱位。本文介绍了我们针对这些儿童盂肱关节畸形采用软组织和骨重建手术的全面的、基于时间的治疗策略。
