Verchere Cynthia, Durlacher Kim, Bellows Doria
Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
Division of Pediatric Plastic Surgery, Department of Surgery, British Columbia Children's Hospital, Vancouver, BC, Canada.
Semin Plast Surg. 2023 Jul 26;37(2):102-107. doi: 10.1055/s-0043-1767783. eCollection 2023 May.
A multidisciplinary team at BC Children's Hospital provides brachial plexus birth injury management for our provincial catchment area. Although compared with many centers we service a relatively small clinic population, we have the benefit of universal health care, province-wide reach, and accessible research infrastructure. In 2008, we created the Sup-ER protocol, which includes an orthosis that passively positions the neonatal shoulder into more idealized glenohumeral contact during early growth. We have since shown that our Sup-ER patients have better shoulder outcomes, require less brachial plexus surgery, and need fewer shoulder tendon transfers than those patients treated in our clinic prior to 2008. We have also found that the rate and degree of elbow flexion contractures are reduced compared with results reported in the literature.
不列颠哥伦比亚省儿童医院的一个多学科团队为我们省的服务区域提供臂丛神经产伤管理。尽管与许多中心相比，我们服务的门诊患者数量相对较少，但我们受益于全民医疗保健、全省覆盖范围以及便捷的研究基础设施。2008年，我们创建了Sup-ER方案，其中包括一种矫形器，可在早期生长过程中被动地将新生儿肩部置于更理想的盂肱关节接触位置。自那以后，我们发现接受Sup-ER方案治疗的患者肩部预后更好，所需的臂丛神经手术更少，且与2008年之前在我们诊所接受治疗的患者相比，需要的肩部肌腱转移手术更少。我们还发现，与文献报道的结果相比，肘屈曲挛缩的发生率和程度有所降低。
