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首页> 美国卫生研究院文献>Clinical Orthopaedics and Related Research >CORR Insights®: What Range of Motion is Achieved Five Years After an External Rotationplasty of the Shoulder in Infants with Obstetric Brachial Plexus Injury?
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CORR Insights®: What Range of Motion is Achieved Five Years After an External Rotationplasty of the Shoulder in Infants with Obstetric Brachial Plexus Injury?

机译：CorrInsights®：在婴儿肩部的外部轮换前五年内实现了哪些动作具有产科臂丛丛损伤的婴儿的外部转移术？

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摘要

There is abundant work on brachial plexus birth palsies and I want to highlight current literature on the indications and results of soft-tissue releases and tendon transfers. While the subscapularis is the most commonly released tendon in this setting, other soft-tissue structures that can be released include the anterior capsule, the coracohumeral ligament, and the pectoralis major (usually as a z-plasty); resection of the coracoid sometimes is done to achieve improvement of global abduction and external rotation of the shoulder. A meta-analysis published in 2013 showed open release of the subscapularis was superior to arthroscopic release to improve global abduction of the shoulder, but improvement of external rotation between the two groups was the same [5]. In contrast, another study found that arthroscopic release of the subscapularis was superior to open z-plasty of the pectoralis major when measuring abduction, Mallet scores, active external rotation and hand-to-head motion. All the children in this study also had latissimus dorsi and teres major tendon transfers done at the same time as the soft-tissue release. It is important to note that this study demonstrated improvement in all children, but recommended consideration of arthroscopic soft-tissue release since it is less invasive [9]. Finally, two studies found remodeling of the glenohumeral joint if the mechanics of the shoulder are restored early. They used MRI or CT to demonstrate a more-central position of the humeral head on the glenoid and improvement of the glenoid retroversion [1, 4].
机译：在肱臂丛丛生Palsies上有丰富的工作，我希望突出目前的文献对软组织释放和肌腱转移的指示和结果。虽然船只是该设置中最常见的肌腱，但是可以释放的其他软组织结构包括前胶囊，鳞状韧带和胸壁（通常为Z形型）;有时会切除吻合吻，以实现肩部的全球绑架和外部旋转的改进。 2013年发布的Meta分析显示，亚西瓜的开放释放优于关节镜释放，以改善肩部的全球绑架，但两组之间的外部旋转的改善是相同的[5]。相比之下，另一项研究发现，当测量绑架，槌评分，有源外部旋转和手头动作时，船只的关节镜释放优于开放的Pectoralis专业Z形型。本研究中的所有儿童也具有Latissimus Dorsi和Teres主要肌腱转移作为软组织释放的同时进行。值得注意的是，本研究表明所有儿童的改善，但建议考虑关节镜软组织释放，因为它较少侵入性[9]。最后，如果早期恢复肩部的机制，则两项研究发现了Glenohumeral接头的重塑。它们使用MRI或CT来证明肱骨头在关节盂上的更中心的位置，并改善关节盂反应[1,4]。

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