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用于创伤性锁骨上臂丛神经麻痹患者连枷肩晚期重建的盂肱关节固定术。

Glenohumeral arthrodesis for late reconstruction of flail shoulder in patients with traumatic supraclavicular brachial plexus palsy.

作者信息

Thangarajah Tanujan, Lambert Simon M

机构信息

The Shoulder and Elbow Service, The Royal National Orthopaedic Hospital, Stanmore, UK.

出版信息

Shoulder Elbow. 2017 Oct;9(4):266-271. doi: 10.1177/1758573217693807. Epub 2017 Feb 13.

Abstract

BACKGROUND

Flail shoulder can occur following a brachial plexus injury and is characterized by painful subluxation of the glenohumeral joint and the inability to independently position the hand in space. The present study aimed to report the clinical outcomes following glenohumeral arthrodesis for late reconstruction of flail shoulder in patients with traumatic supraclavicular brachial plexus palsy.

METHODS

Seven patients were included in the present study and were followed-up for a mean of 98 months (range 27 months to 197 months). The mean age at the time of surgery was 48 years (range 28 years to 80 years) and the mean time to surgery from injury was 5 years (range 2.5 years to 8 years).

RESULTS

Six patients achieved bony union with a mean time to fusion of 4.7 months (range 2 months to 8 months). Non-union occurred in one case. The mean Oxford Shoulder Score improved from 11 pre-operatively (range 4 to 16) to 27 postoperatively (range 16 to 40) ( = 0.016), and the mean Subjective Shoulder Value improved from 7 (range 0 to 15) pre-operatively to 45 (range 15 to 100) postoperatively ( = 0.029).

CONCLUSIONS

In our series, glenohumeral arthrodesis was associated with few complications, and effectively reduced pain and improved functional outcome in this selected patient population.

摘要

背景

连枷肩可发生于臂丛神经损伤后,其特征为肩肱关节疼痛性半脱位以及无法将手独立置于空间中。本研究旨在报告创伤性锁骨上臂丛神经麻痹患者行肩肱关节融合术晚期重建连枷肩后的临床结果。

方法

本研究纳入7例患者,平均随访98个月(范围27个月至197个月)。手术时的平均年龄为48岁(范围28岁至80岁),受伤至手术的平均时间为5年(范围2.5年至8年)。

结果

6例患者实现骨愈合,平均融合时间为4.7个月(范围2个月至8个月)。1例发生骨不连。牛津肩评分平均从术前的11分(范围4至16分)提高到术后的27分(范围16至40分)(=0.016),主观肩值平均从术前的7分(范围0至15分)提高到术后的45分(范围15至100分)(=0.029)。

结论

在我们的系列研究中,肩肱关节融合术并发症较少,并有效减轻了该特定患者群体的疼痛,改善了功能结果。

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