Scottish National Brachial Plexus Injury Service, Queen Elizabeth University Hospital and Royal Hospital for Children, Glasgow, UK.
J Hand Surg Eur Vol. 2022 Dec;47(11):1121-1127. doi: 10.1177/17531934221121912. Epub 2022 Sep 1.
A prospective database study was undertaken to investigate the severity and progression of elbow and forearm contractures in patients with obstetric brachial plexus injury. One-hundred and fifty-nine patients, who had not undergone nerve repair (mean age 12 years at last follow-up) (56 Narakas Group 1, 66 Group 2, 27 Group 3, 10 Group 4) were studied. Mean fixed flexion of the elbow at last follow-up was 13° for Group 1, 15° for Group 2, 19° for Group 3 and 24° for Group 4. Severe contracture of 30° or more developed in 31 children (mean age 118 months), with poorer active shoulder abduction being a significant risk factor. Onset of contracture was before the age of 5 years but did not increase substantially beyond 12 years. Active and passive pronation and supination tended to decrease with increasing injury severity. Seventeen children developed severe restriction of passive pronation (supination contracture) (mean age 69 months), and 12 developed severe restriction of passive supination at a mean of 137 months. III.
一项前瞻性数据库研究旨在调查产伤性臂丛神经损伤患者肘部和前臂挛缩的严重程度和进展。对 159 名未行神经修复的患者（末次随访时的平均年龄为 12 岁）（56 名 Narakas 1 组，66 名 2 组，27 名 3 组，10 名 4 组）进行了研究。末次随访时，1 组患者的肘部固定屈曲平均为 13°，2 组为 15°，3 组为 19°，4 组为 24°。31 名儿童（平均年龄 118 个月）出现严重挛缩 30°或以上，且主动肩关节外展较差是一个显著的危险因素。挛缩的起始年龄在 5 岁之前，但在 12 岁之后并未显著增加。主动和被动旋前和旋后往往随着损伤严重程度的增加而减少。17 名儿童出现严重的被动旋前受限（旋后挛缩）（平均年龄 69 个月），12 名儿童在平均 137 个月时出现严重的被动旋后受限。
