Department of Orthopedics and Traumatology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
Clinics (Sao Paulo). 2013 Jul;68(7):928-33. doi: 10.6061/clinics/2013(07)07.
To evaluate the functional and radiographic results in patients undergoing shoulder anterior soft tissue stretching in association with open reduction and internal rotation osteotomy to centralize the humeral head as a treatment for Erb-Duchenne obstetric palsy sequelae.
A total of 35 patients underwent this surgical treatment, and the mean follow-up was 4.6 years. The Mallet scale was applied before and after the surgical procedure. A total of 20 patients underwent computed tomography to assess the glenoid version and humeral head subluxation.
Functional improvement was achieved, as evidenced by an increase in the Mallet scale score from 12.14 to 16.46 (p<0.001). The correction of retroversion was achieved once the glenoid version ranged from -21.4 to -12 degrees (p<0.001). The humeral head subluxation improved from 6.5 to 35.2% (p<0.001). Patients older than 6 years of age did not achieve glenohumeral joint improvement with respect to dysplastic abnormalities.
Internal rotation osteotomy in association with the stretching of anterior soft tissues of the shoulder in patients under the age of 7 years provided improvements in the function, retroversion, and subluxation of the glenohumeral joint.
评估肩关节前方软组织伸展联合切开复位内旋截骨术治疗 Erb-Duchenne 产伤后手瘫后遗症患者的功能和影像学结果。
共 35 例患者接受了这种手术治疗，平均随访 4.6 年。手术前后应用 Mallet 量表进行评估。共有 20 例患者接受了 CT 检查，以评估肩胛盂倾斜度和肱骨头半脱位情况。
Mallet 量表评分从 12.14 分增加到 16.46 分（p<0.001），提示功能改善。当肩胛盂倾斜度从-21.4 度变为-12 度时，实现了后倾的矫正（p<0.001）。肱骨头半脱位从 6.5%改善到 35.2%（p<0.001）。年龄大于 6 岁的患者在肩盂肱关节的改善方面未能克服发育不良异常。
7 岁以下患者的肩关节前方软组织伸展联合内旋截骨术可改善肩关节功能、后倾和半脱位。
