Department of Orthopaedics, 1st Faculty of Medicine Charles University and Hospital Na Bulovce, Budínova 2, 18081, Prague 8, Czech Republic,
Int Orthop. 2014 Apr;38(4):803-10. doi: 10.1007/s00264-013-2202-0. Epub 2013 Dec 6.
Latissimus dorsi and teres major transfers to the lateral side of the humerus with lengthening of the pectoralis major and subscapularis muscles for residual shoulder deformity were compared in children and skeletally mature patients.
Fifteen patients (nine children, six skeletally mature patients aged three to 30 years, follow-up one to 22 years) were treated for internal shoulder contracture after birth plexus lesions: C5-C6 (seven patients); C5-7 (five patients); C5-C8-T1 (three patients, respectively). Range of movement, Mallet shoulder function score and radiographs were assessed.
Pre-operatively, shoulder function restrictions were comparable in all patients. Postoperatively, external rotation, abduction and Mallet function score improved significantly (p < 0.05) in all patients except one. There were no differences in improvement between children and skeletally mature patients (p = 0.24-1.0).
This technique improves external rotation and abduction of the shoulder for daily living activities in children and young, skeletally mature, patients.
比较儿童和骨骼成熟患者中,通过延长胸大肌和肩胛下肌,将背阔肌和大圆肌转移到肱骨外侧,以矫正残余肩部畸形的效果。
15 名患者(9 名儿童,6 名 3 至 30 岁骨骼成熟患者,随访 1 至 22 年)因出生性臂丛神经损伤而接受治疗:C5-C6(7 名患者);C5-7(5 名患者);C5-C8-T1(3 名患者)。评估了活动范围、Mallet 肩部功能评分和 X 光片。
术前,所有患者的肩部功能受限情况相似。术后,除 1 名患者外,所有患者的外旋、外展和 Mallet 功能评分均显著改善(p<0.05)。儿童和骨骼成熟患者在改善程度方面无差异(p=0.24-1.0)。
该技术可改善儿童和年轻骨骼成熟患者的日常生活中肩部的外旋和外展功能。