CAJ | 학술논문

目的探讨儿童三角肌挛缩症的病因及手术治疗效果.方法回顾性研究1999年9月至2010年3月手术治疗的23例三角肌挛缩患儿,23例患儿中双侧3例,发病年龄2个月至11岁,手术时平均年龄:9岁(5～14岁).8例有反复三角肌肌肉注射史.手术行挛缩带松解,采用近端的横行或T形切口,或巾远段的纵弧形切口,彻底松解粘连及挛缩组织,术后第二天开始主被动功能锻炼.结果术中发现挛缩条带多位于三角肌中后部,部分深达关节囊,术后全组病例肩关节活动度完全恢复,肩关节外展畸形消失,三角肌肌力正常,2例残留轻度翼状肩胛(8％),11例出现瘢痕肥大(42％).结论三角肌挛缩症为多因素致病,手术松解效果良好,手术应考虑尽量减少瘢痕,增加患儿满意程度.
목적 탐토인동삼각기련축증적병인급수술치료효과.방법 회고성연구1999년9월지2010년3월수술치료적23례삼각기련축환인,23례환인중쌍측3례,발병년령2개월지11세,수술시평균년령:9세(5～14세).8례유반복삼각기기육주사사.수술행련축대송해,채용근단적횡행혹T형절구,혹건원단적종호형절구,철저송해점련급련축조직,술후제이천개시주피동공능단련.결과 술중발현련축조대다위우삼각기중후부,부분심체관절낭,술후전조병례견관절활동도완전회복,견관절외전기형소실,삼각기기력정상,2례잔류경도익상견갑(8％),11례출현반흔비대(42％).결론 삼각기련축증위다인소치병,수술송해효과량호,수술응고필진량감소반흔,증가환인만의정도.
Objective To evaluate the causes and clinical results of surgical treatment for deltoid contracture in children.Methods The results of surgical treatment for dehoid contracture in 23 children (26 shoulders) over 2.2 years period were reviewed.The causes and clinical results were analyzed.Results The disease was first noticed hetween 2 months to 11 years old in the 23 patients.Multiple intra-muscular injections were found in 8 patients.Surgical treatment was performed to completely release the contractures fibrous band.Either curved longitudinal incision or transverse incision or T shape incision was used.Passive and active exercise was done 2nd day postoperatively.Fibrous band contractures were mostly found in mid-posterior part of deltoid.All shoulders achieved a full range of motion and power,and the abduction deformity disappeared post-operatively.Two patients had mild residual winged scapular (8％).Eleven patients had hypertrophy scar (42％).Conclusions Contracture of deltoid muscle may be caused by multiple factors.Surgical release of the contractures can achieve good results.The surgeon should take care to try reduce hypertrophy scar formation.