Ivalde Flavio César, Marazita-Valverde José, Bataglia Danilo
Peripheral Nerve & Brachial Plexus Surgery Program, Department of Orthopedics, University of Buenos Aires School of Medicine, Argentina.
Peripheral Nerve & Brachial Plexus Surgery Program, Department of Physiotherapy, University of Buenos Aires School of Medicine, Argentina.
Maedica (Bucur). 2019 Dec;14(4):418-421. doi: 10.26574/maedica.2019.14.4.418.
In brachial plexus injuries, external rotation in patients with a moderate to severe glenohumeral dysplasia is corrected with derotational humeral osteotomy surgery. The most frequent complications described for this procedure include keloid scar, loss of external rotation secondary to bone remodelling, loss of internal rotation, prominence of osteosynthesis, fracture distal to the plate transient ulnar paraesthesia and radial nerve palsy (1), and delayed union and non-union. Rarely, treating complications associated with derotational humeral osteotomy may require revision of osteosynthesis (2). The literature that investigates the effectiveness of derotational humeral osteotomy as a procedure to rescue dorsal infraspinatus tendon transfer is limited. This article is the first communication of a pediatric patient with an obstetric brachial plexus injury receiving a derotational osteotomy as a procedure to salvage a failed rescue Latissimus dorsi tendon transfer with a complication. This case report was performed according to the principles of the Declaration of Helsinki. Written informed consent for participation in this case report was obtained from the patient's parents.
在臂丛神经损伤中，对于中重度肩肱关节发育不良患者，通过肱骨旋转截骨手术纠正外旋。该手术最常见的并发症包括瘢痕疙瘩、由于骨重塑导致的外旋丧失、内旋丧失、骨固定突出、钢板远端骨折、短暂性尺侧感觉异常和桡神经麻痹（1），以及延迟愈合和不愈合。很少情况下，治疗与肱骨旋转截骨相关的并发症可能需要进行骨固定翻修（2）。研究肱骨旋转截骨作为挽救背阔肌肌腱转移失败手术的有效性的文献有限。本文首次报道了一名患有产瘫性臂丛神经损伤的儿科患者接受旋转截骨手术，以挽救失败的背阔肌肌腱转移并伴有并发症的情况。本病例报告是根据《赫尔辛基宣言》的原则进行的。已获得患者父母参与本病例报告的书面知情同意书。
