Torode I, Donnan L
Royal Children's Hospital, Parkville, Victoria, Australia.
J Pediatr Orthop. 1998 Sep-Oct;18(5):611-5. doi: 10.1097/00004694-199809000-00011.
Twelve children with obstetric paralysis were diagnosed as having a posterior dislocation of the humeral head. The diagnosis was suspected on clinical grounds and confirmed by computed tomography (CT) scans in all cases. All 12 patients were treated with open reduction via an anterior approach. The age range at the time of surgery was from 7 months to 7 years (average, 2 years and 3 months). All patients were immobilized in a shoulder spica for 6 weeks and a further 6 weeks in an orthosis. All patients were examined by CT scans in the postoperative period, which confirmed a satisfactory reduction in all cases. With a minimal follow-up of 12 months, there have been no redislocations. This article demonstrates that dislocation of the shoulder in association with obstetric paralysis is not rare, as previously described, and shows that once diagnosed, the dislocation can be satisfactorily treated by a single anterior open reduction of the shoulder.
12名患有产瘫的儿童被诊断为肱骨头后脱位。临床上怀疑有该诊断，所有病例均经计算机断层扫描（CT）证实。所有12例患者均通过前路切开复位进行治疗。手术时的年龄范围为7个月至7岁（平均2岁3个月）。所有患者均在肩人字石膏中固定6周，之后再使用矫形器固定6周。所有患者在术后均接受了CT扫描检查，结果证实所有病例复位情况均令人满意。随访至少12个月，未出现再脱位情况。本文表明，与产瘫相关的肩关节脱位并不像之前所描述的那样罕见，并且表明一旦确诊，通过单次肩关节前路切开复位即可对脱位进行令人满意的治疗。
