Aly A, Bahm J, Schuind F
Department of Orthopaedics and Traumatology, Erasme University Hospital, Brussels, Belgium.
Department of Orthopaedics and Traumatology, Erasme University Hospital, Brussels, Belgium
J Hand Surg Eur Vol. 2014 Jun;39(5):549-52. doi: 10.1177/1753193413492058. Epub 2013 Jun 7.
Thirty three per cent of children with obstetrical brachial plexus palsy with incomplete neurological recovery develop shoulder internal contracture associated with osseous deformity. Some of the older children are treated by humeral derotational osteotomy. The classical technique of open approach to the humeral diaphysis and plate fixation imposes a longitudinal scar and carries significant risks (nonunion, nerve palsy); a secondary procedure for plate removal is necessary in a significant proportion of patients. The authors report a new technique of percutaneous humeral osteotomy with osteosynthesis by Hoffmann external fixator. In six cases bone healing was obtained at an average of 45 days, without adverse complication. The postoperative results showed improved shoulder function. This new technique is simple and safe; it represents a new option for the treatment of sequelae of obstetrical brachial plexus palsy.
33%神经功能未完全恢复的产瘫患儿会出现与骨畸形相关的肩部内收挛缩。部分大龄儿童需接受肱骨旋转截骨术治疗。经典的肱骨骨干切开复位钢板内固定术会遗留纵向瘢痕，且风险较大（骨不连、神经麻痹）；相当一部分患者还需二次手术取出钢板。作者报告了一种采用霍夫曼外固定器进行经皮肱骨截骨及骨固定的新技术。6例患者平均45天实现骨愈合，无不良并发症。术后结果显示肩部功能有所改善。这项新技术操作简单且安全；为产瘫后遗症的治疗提供了新选择。
