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盂肱关节脱位在儿童肱骨近端骨折中罕见:描述性研究和文献回顾。

Glenohumeral joint dislocation is rare in children with proximal humeral fractures: a descriptive study and literature review.

机构信息

Department of Orthopaedic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.

Department of Orthopaedics and Trauma Surgery, Blue Cross Hospital, Tripureswor, Kathmandu, 44600, Nepal.

出版信息

BMC Musculoskelet Disord. 2022 Jan 5;23(1):36. doi: 10.1186/s12891-021-04992-1.

Abstract

BACKGROUND

Glenohumeral dislocation combined with fracture of the proximal humerus is extremely rare in children, and this study aims to investigate its incidence in the pediatric population and review the treatment strategy for this condition.

METHODS

Between Jan 2014 and Jan 2019, 280 patients with unilateral proximal humeral fractures were retrospectively reviewed. Imaging and follow-up notes were reviewed for patients with a predilection for glenohumeral joint dislocation. Six (2.14%) patients between the ages of 5 and 10 years were confirmed as glenohumeral joint dislocation and included in the study. All these patients underwent closed reduction and external fixation under general anesthesia.

RESULTS

Out of 280 patients with proximal humeral fractures, only 6 patients, including 4 males and 2 females, were confirmed as glenohumeral joint dislocation. ROM was normal compared with the contralateral shoulder in every patient at the last follow-up. There was no case of radiological abnormality, including avascular necrosis or devascularization of the humeral head.

CONCLUSIONS

Glenohumeral dislocation is a rare entity associated with the proximal humerus fracture in children, with an overall incidence in our case series was 2.14%. Reduction and stabilization of such injury using an external fixator is a suitable choice for pediatric patients that failed closed reduction.

摘要

背景

儿童盂肱关节脱位合并肱骨近端骨折极为罕见,本研究旨在探讨其在儿科人群中的发病率,并复习该疾病的治疗策略。

方法

回顾性分析 2014 年 1 月至 2019 年 1 月期间 280 例单侧肱骨近端骨折患儿的临床资料。对易发生盂肱关节脱位的患儿的影像学和随访资料进行评估。6 例(2.14%)5 至 10 岁患儿确诊为盂肱关节脱位,纳入本研究。所有患儿均在全身麻醉下行闭合复位和外固定治疗。

结果

280 例肱骨近端骨折患儿中,仅有 6 例(4 男 2 女)患儿确诊为盂肱关节脱位。末次随访时,所有患儿患侧肩关节活动度均与健侧相同。所有患儿均未出现影像学异常,包括肱骨头缺血性坏死或骨坏死。

结论

盂肱关节脱位是儿童肱骨近端骨折的一种罕见并发症,在本研究系列中总体发生率为 2.14%。对于闭合复位失败的此类损伤,使用外固定架进行复位和固定是儿科患者的一种合适选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3059/8734332/bf1031faf1e0/12891_2021_4992_Fig1_HTML.jpg

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