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改良 Woodward 技术治疗 Sprengel 畸形及 Cavendish 分类改良

Modified Woodward Technique for Sprengel Deformity and a Modification of the Cavendish Classification.

机构信息

Department of Orthopaedics and Traumatology, Metin Sabanci Baltalimani Bone Diseases Education and Research Hospital, Istanbul, Turkey.

出版信息

J Pediatr Orthop. 2020 Sep;40(8):401-407. doi: 10.1097/BPO.0000000000001582.

Abstract

INTRODUCTION

Sprengel deformity (SD) is the most common congenital anomaly of the shoulder. Surgery is required for moderate and severe forms. The modified Woodward procedure is the most widely used procedure for the surgical treatment.

METHODS

SD patients who applied to our institution between 2005 and 2018 were retrospectively reviewed. A modification of the Cavendish classification was used for preoperative and postoperative evaluations.

RESULTS

Eighteen shoulders of 17 (mean age: 8.5 y, range: 2 to 18 y, 5 males and 12 females) patients were included. The right, left, and bilateral shoulders were affected in 9, 7, and 1 cases, respectively. The mean follow-up time was 62.9 months (12 to 161 mo). Preoperatively, 3 shoulders were type 2, 12 shoulders were type 3, and 3 shoulders were type 4 according to the Cavendish classification and 2 shoulders were type 0, 6 shoulders were type 1, and 10 shoulders were type 2 postoperatively.

CONCLUSIONS

Periscapular congenital malformations play a significant role in range of motion limitation. The modified Woodward procedure is a viable alternative in the surgical treatment of SD and the proposed modification of Cavendish classification (grade 0) is functional.

摘要

引言

Sprengel 畸形(SD)是肩部最常见的先天性异常。中重度畸形需要手术治疗。改良 Woodward 手术是治疗该病最常用的手术方法。

方法

回顾性分析 2005 年至 2018 年期间我院收治的 SD 患者。采用 Cavendish 分类的改良方法进行术前和术后评估。

结果

17 名患者(18 个肩膀,平均年龄 8.5 岁,范围 2 至 18 岁,男 5 例,女 12 例)纳入研究。右侧、左侧和双侧肩膀受累的患者分别为 9、7 和 1 例。平均随访时间为 62.9 个月(12 至 161 个月)。术前,根据 Cavendish 分类,3 个肩膀为 2 型,12 个肩膀为 3 型,3 个肩膀为 4 型,术后 2 个肩膀为 0 型,6 个肩膀为 1 型,10 个肩膀为 2 型。

结论

肩胛带先天性畸形对活动范围受限有重要影响。改良 Woodward 手术是治疗 SD 的一种可行方法,我们提出的 Cavendish 分类改良(0 级)是有效的。

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