Huber H, Gerber C
Hospital Balgrist, University of Zurich, Switzerland.
J Bone Joint Surg Br. 1994 Jan;76(1):118-22.
We reviewed 25 children who presented consecutively with voluntary (habitual) subluxation of the shoulder. Thirty-six shoulders were involved and symptoms had been present for an average period of 12 years. Eighteen children were managed by 'skillful neglect': all these had become fully active in the profession of their choice and were satisfied with the outcome. Two of them had required shoulder surgery in adult life but only after trauma. Seven children (ten shoulders) had undergone stabilising operations during childhood with the aim of preventing later degenerative arthritis. These patients were also active in their selected professions, but only three (five of the ten shoulders) had good results: two shoulders had recurrent instability, two were painful and one was stiff. None of the shoulders in either group had developed osteoarthritic changes. There was no association with emotional or psychiatric problems. We conclude that voluntary subluxation of the shoulder in children has a favourable prognosis and that there is no indication for surgical intervention during childhood.
我们回顾了25例因习惯性肩关节半脱位而连续就诊的儿童患者。共累及36个肩关节，症状平均持续12年。18名儿童采用“巧妙忽视”的方法进行处理：所有这些儿童都在他们选择的职业中充分活跃，并对结果感到满意。其中两人在成年后需要进行肩部手术，但均是在创伤后。7名儿童（10个肩关节）在儿童期接受了稳定手术，目的是预防后期的退行性关节炎。这些患者在他们选择的职业中也很活跃，但只有3名患者（10个肩关节中的5个）取得了良好的效果：2个肩关节反复出现不稳定，2个疼痛，1个僵硬。两组中的肩关节均未出现骨关节炎改变。与情感或精神问题无关。我们得出结论，儿童习惯性肩关节半脱位预后良好，儿童期没有手术干预的指征。
