Silva Bruno Liberato de Souza, Kimura Luiz Koiti, Crepaldi Bruno Eiras, Mattar Rames, Cho Álvaro Baik, Oviedo Rubén Montiel
Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, São Paulo, SP, Brazil, Instituto de Ortopedia e Traumatologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
Acta Ortop Bras. 2015 Jan-Feb;23(1):22-5. doi: 10.1590/1413-78522015230101023.
To demonstrate the importance of performing early shoulder tomography in patients with obstetric brachial plexus palsy (OBPP).
This series of cases retrospective study with level evidence IV was conducted by consulting 76 patient's medical records with OBPP divided into three age groups: ≤12 months, 13 to 24 months and ≥ 25 months. The patients were classified according to gender, affected side, type of paralysis according to Narakas classification, and by computed tomography, according to the Waters scale.
The association between the age groups with Waters classification was statistically significant (p=0,006), showing that patients in the group aged less than 12 months and in the group aged between 12 and 24 months had a relevant correlation between the physical examination and Waters > III when compared to patients from groups aged 25 months or older.
This study shows a correlation between the findings in the physical examination and severe dysplasia on the shoulder of children under 24 months of age, justifying the early tomographic shoulder exam in order to achieve a better follow-up and a consider a more aggressive approach in the treatment of OBPP affected children. Level of Evidence IV, Case Series.
证明对产瘫性臂丛神经麻痹（OBPP）患者进行早期肩部断层扫描的重要性。
通过查阅76例OBPP患者的病历进行了这一IV级证据的系列病例回顾性研究，这些患者分为三个年龄组：≤12个月、13至24个月和≥25个月。根据性别、患侧、按照纳拉卡斯分类法的麻痹类型以及通过计算机断层扫描按照沃特斯量表对患者进行分类。
年龄组与沃特斯分类之间的关联具有统计学意义（p = 0.006），表明与25个月及以上年龄组的患者相比，年龄小于12个月组和12至24个月组的患者在体格检查与沃特斯>III之间存在显著相关性。
本研究表明24个月以下儿童的体格检查结果与肩部严重发育异常之间存在相关性，这证明了早期肩部断层扫描检查的合理性，以便更好地进行随访并在治疗产瘫性臂丛神经麻痹患儿时考虑采取更积极的方法。证据级别IV，病例系列。
