CAJ | 학술논문

目的初步探讨前路软组织松解加肱骨旋转截骨术和单纯肩关节前路松解术治疗大龄产瘫后肩关节内旋挛缩畸形的疗效.方法 1999年8月～2007年1月,对32例大龄产瘫后肩关节内旋挛缩畸形的患者,其中17例采用前路软组织松解加肱骨旋转截骨术,另15例采用单纯肩关节前路松解术.结果术后随访1～9年,按Mallet评分方法评定:前路软组织松解+肱骨旋转截骨(A组)术后平均得分从术前的8.5分上升到1 1.0分;单纯肩关节前路松解(B组)术后平均得分从术前的7.7分上升到8.7分.按Gilbert分级方法评定:A组术后平均级别由术前的2.0级上升到术后的4.0级;B组术后平均级别由术前的2.0级上升到术后的2.8级.结论肱骨旋转截骨是治疗大龄产瘫后肩关节内旋挛缩畸形的有效方法.
목적 초보탐토전로연조직송해가굉골선전절골술화단순견관절전로송해술치료대령산탄후견관절내선련축기형적료효.방법 1999년8월～2007년1월,대32례대령산탄후견관절내선련축기형적환자,기중17례채용전로연조직송해가굉골선전절골술,령15례채용단순견관절전로송해술.결과 술후수방1～9년,안Mallet평분방법평정:전로연조직송해+굉골선전절골(A조)술후평균득분종술전적8.5분상승도1 1.0분;단순견관절전로송해(B조)술후평균득분종술전적7.7분상승도8.7분.안Gilbert분급방법평정:A조술후평균급별유술전적2.0급상승도술후적4.0급;B조술후평균급별유술전적2.0급상승도술후적2.8급.결론 굉골선전절골시치료대령산탄후견관절내선련축기형적유효방법.
Objective To investigate the treatment outcomes of rotation osteetomy and anterior release for medial rotation contracture of the shoulder in obstetric brachial plexus palsy (OBPP) in older children.Methods Thirty-two eases of medial rotation contracture of the shoulder incurred as a sequela of OBPP who were treated between August 1999 and January 2007 were reviewed.Fifteen patients underwent anterior release of the eontracture soft tissues only.Seventeen patients had rotation osteotomy of the humerus and anterior release.Mallet score and Gilbert grading system were used to evaluate the function pre-and postoperatively.Results The patients were followed-up for 1 to 9 years.Mallet score of the patients who had anterior release and rotation osteotom7 (group A) increased from an average of 8.5 to 11.0.The average Mallet score of patients who had anterior release only ( group B) increased from 7.7 preoperatively to 8.7 postoperatively.Gilbert score of group A increased from grade 2.0 to grade 4.O,while Gilbert score of group B only changed from grade 2.0 to grade 2.8. ConclusionRotation ostectomy is the effective procedure for the medial rotation contracture of the shoulder in obstetric brachial plexus palsy in eider children.