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产瘫性臂丛神经麻痹患者上肢长度差异的检查

Examination of Upper Extremity Length Discrepancy in Patients with Obstetric Brachial Plexus Paralysis.

作者信息

Danisman Murat, Emet Abdulsamet, Kocyigit Ismail Aykut, Hassa Ercan, Uzumcugil Akin

机构信息

Department of Orthopedics and Traumatology, Faculty of Medicine, Giresun University, Giresun 28100, Turkey.

Department of Orthopedics and Traumatology, Etlik City Hospital, Ankara 06170, Turkey.

出版信息

Children (Basel). 2023 May 13;10(5):876. doi: 10.3390/children10050876.

Abstract

Since the natural course of obstetric brachial plexus palsy is variable, several problems are encountered. One important question, in considering patients with OBPP under observation in outpatient clinical settings, is whether children will have length discrepancies in their arms. The aim of this study was to determine differences in the length of the affected extremity, in comparison to the opposite upper extremity. As such, 45 patients, aged 6 months to 18 years, with unilateral brachial plexus palsy developed due to obstetric reasons, were included in the study. Affected and healthy side humerus, ulna, radius, 2nd metacarpal and 5th metacarpal lengths were evaluated according to gender, age, side, Narakas classification, primary and secondary surgery. Statistically significant differences were found in the change rates of affected/healthy humerus, radius, 2nd metacarpal and 5th metacarpal lengths according to age (93%, 95%, 92%, 90% and 90%, respectively). Affected/healthy change rates of ulna, radius, 2nd metacarpal and 5th metacarpal lengths were found to differ statistically ( < 0.05) according to the Narakas classification variable (94%, 92%, 95%, 94% and 94%, respectively). There were no statistically significant differences in the ratios of affected/healthy change in the lengths of the humerus, ulna, radius and 5th metacarpal compared to the primary surgery ( > 0.05). The ratios of affected/healthy change in ulna, radius and 5th metacarpal lengths were found to differ statistically ( < 0.05) according to secondary surgeries (93%, 91%, 91% and 92%, respectively). Joint and bone deformities and bone shortening were observed after changes that occurred in the postnatal and growing periods due to obstetric brachial plexus palsy. Every increase in function to be gained in the upper extremity musculature was also potentially able to reduce problems, such as shortness.

摘要

由于产科臂丛神经麻痹的自然病程具有变异性,因此会遇到几个问题。在门诊临床环境中观察患有产科臂丛神经麻痹的患者时,一个重要问题是儿童的手臂是否会出现长度差异。本研究的目的是确定患侧肢体与对侧上肢相比在长度上的差异。因此,本研究纳入了45例因产科原因导致单侧臂丛神经麻痹的患者,年龄在6个月至18岁之间。根据性别、年龄、患侧、纳拉卡斯分类、一期和二期手术情况,对患侧和健侧的肱骨、尺骨、桡骨、第二掌骨和第五掌骨长度进行了评估。根据年龄,患侧/健侧肱骨、桡骨、第二掌骨和第五掌骨长度的变化率存在统计学显著差异(分别为93%、95%、92%、90%和90%)。根据纳拉卡斯分类变量,尺骨、桡骨、第二掌骨和第五掌骨长度的患侧/健侧变化率存在统计学差异(<0.05)(分别为94%、92%、95%、94%和94%)。与一期手术相比,肱骨、尺骨、桡骨和第五掌骨长度的患侧/健侧变化率无统计学显著差异(>0.05)。根据二期手术情况,尺骨、桡骨和第五掌骨长度的患侧/健侧变化率存在统计学差异(<0.05)(分别为93%、91%、91%和92%)。在产后和生长发育期,由于产科臂丛神经麻痹发生变化后,观察到关节和骨骼畸形以及骨骼缩短。上肢肌肉组织功能的每一次改善也有可能减少诸如短小等问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a7ad/10217098/28df44db8139/children-10-00876-g001.jpg

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