Richards R R, Waddell J P, Hudson A R
Clin Orthop Relat Res. 1985 Sep(198):250-8.
In 14 adult patients with brachial plexus injuries, shoulder arthrodesis was completed in a position of 30 degrees abduction, 30 degrees flexion, and 30 degrees internal rotation. Abduction was measured by the position of the arm in relation to the side of the body with the scapula in the anatomic position. Internal fixation was used in each case. Six patients had had Steindler procedures. Three patients with complete paralysis were treated by above-elbow amputation. All shoulders fused. Mean follow-up time was 32 months. All patients noted that shoulder fusion had improved the function of their extremities. Minimum shoulder motion was 60 degrees abduction and 50 degrees flexion. Three procedures failed because of continued pain that was not relieved by surgery. One patient with an elbow flexion contracture disliked the combination of shoulder and elbow flexion. Seven patients required plate removal. Only one of the three patients who had had above-elbow amputation became a good prosthetic user. Shoulder arthrodesis is a reliable procedure that improves function in adult patients with brachial plexus palsy.
在14例成人臂丛神经损伤患者中，肩关节融合术在肩关节外展30度、前屈30度和内旋30度的位置完成。外展通过手臂相对于身体侧面的位置来测量，肩胛骨处于解剖位置。每例均采用内固定。6例患者曾接受施泰德勒手术。3例完全瘫痪患者接受了肘上截肢术。所有肩关节均融合。平均随访时间为32个月。所有患者均指出肩关节融合改善了其肢体功能。肩关节最小活动度为外展60度和前屈50度。3例手术失败，原因是持续疼痛未通过手术缓解。1例肘关节屈曲挛缩患者不喜欢肩关节和肘关节屈曲的组合。7例患者需要取出钢板。3例接受肘上截肢术的患者中只有1例成为了良好的假肢使用者。肩关节融合术是一种可靠的手术方法，可改善成人臂丛神经麻痹患者的功能。
