肩胛上神经损伤合并肩关节骨性关节炎的产科臂丛神经麻痹反向肩关节置换术的临床疗效

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma Pub Date : 2025-06-09 DOI:10.1016/j.jcot.2025.103096

F. Granata , S. D'Amato , S. Cassaro , C. Burgio , F. Bosco

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引用次数: 0

摘要

背景：未经治疗的产科臂丛神经麻痹（OBPP）表现为各种上肢损伤，包括肌肉无力、软组织挛缩和骨关节畸形。反向肩关节置换术（RSA）调节旋转中心，优化三角肌功能以弥补OBPP造成的缺陷。本研究评估了RSA在未治疗的肩胛上神经和终末期盂肱骨关节炎（OA）的OBPP患者中的有效性，重点关注功能和生活质量的改善。方法回顾性分析累及肩胛上神经和终末期盂肱骨关节炎的OBPP行RSA手术的患者。纳入的患者有明显的冈上肌和冈下肌缺陷，但保留了三角肌功能。术前和术后评估包括活动范围（ROM）、视觉模拟量表（VAS）和患者报告的结果测量（PROMs）。还收集了并发症和翻修手术的数据。结果7例患者(男2例，女5例；平均年龄38.9±14.9岁，中位随访时间3.1±2.2年。术后，观察到肢体功能和生活质量的显著改善，反映在肩部稳定评分（CSS）、牛津肩部评分（OSS）和手臂、肩膀和手的快速残疾（QDASH）中。疼痛程度明显减轻，ROM中度增加。无并发症或翻修手术报道。结论srsa是一种有效且安全的手术选择，适用于未经治疗的肩胛上神经和终末期盂肱骨关节炎的OBPP患者，在短期和中期随访中可显著改善患者的功能和生活质量。无并发症和翻修手术进一步支持了其在这一具有挑战性的患者群体中的可靠性。证据水平：

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Clinical outcomes of reverse shoulder arthroplasty in obstetric brachial plexus palsy with suprascapular nerve injury and glenohumeral osteoarthritis

Background

Untreated obstetric brachial plexus palsies (OBPP) present with various upper limb impairments, including muscle weakness, soft tissue contractures, and osteoarticular deformities. Reverse shoulder arthroplasty (RSA) medializes the center of rotation, optimizing deltoid function to compensate for deficits caused by OBPP. This study evaluates the effectiveness of RSA in patients with untreated OBPP involving the suprascapular nerve and end-stage glenohumeral osteoarthritis (OA), focusing on functional and quality-of-life improvements.

Methods

A retrospective analysis was performed on patients with OBPP involving the suprascapular nerve and end-stage glenohumeral OA who underwent RSA. Included patients had significant deficits in the supraspinatus and infraspinatus muscles but preserved deltoid function. Pre- and postoperative assessments included Range of Motion (ROM), Visual Analog Scale (VAS), and Patient-Reported Outcome Measures (PROMs). Data on complications and revision surgeries were also collected.

Results

Seven patients (2 males, 5 females; mean age 38.9 ± 14.9 years) with a median follow-up of 3.1 ± 2.2 years were included. Postoperatively, significant improvements were observed in limb function and quality of life, as reflected in the Constant Shoulder Score (CSS), Oxford Shoulder Score (OSS), and Quick Disabilities of the Arm, Shoulder, and Hand (QDASH). Pain levels decreased markedly, and ROM showed a moderate increase. No complications or revision surgeries were reported.

Conclusions

RSA is an effective and safe surgical option for patients with untreated OBPP involving the suprascapular nerve and end-stage glenohumeral OA, yielding significant functional and quality-of-life improvements at short- and mid-term follow-up. The absence of complications and revision surgeries further supports its reliability in this challenging patient population.

Level of evidence

IV.

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来源期刊

Journal of Clinical Orthopaedics and Trauma Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

0.00%

发文量

181

审稿时长

92 days

期刊介绍： Journal of Clinical Orthopaedics and Trauma (JCOT) aims to provide its readers with the latest clinical and basic research, and informed opinions that shape today''s orthopedic practice, thereby providing an opportunity to practice evidence-based medicine. With contributions from leading clinicians and researchers around the world, we aim to be the premier journal providing an international perspective advancing knowledge of the musculoskeletal system. JCOT publishes content of value to both general orthopedic practitioners and specialists on all aspects of musculoskeletal research, diagnoses, and treatment. We accept following types of articles: • Original articles focusing on current clinical issues. • Review articles with learning value for professionals as well as students. • Research articles providing the latest in basic biological or engineering research on musculoskeletal diseases. • Regular columns by experts discussing issues affecting the field of orthopedics. • "Symposia" devoted to a single topic offering the general reader an overview of a field, but providing the specialist current in-depth information. • Video of any orthopedic surgery which is innovative and adds to present concepts. • Articles emphasizing or demonstrating a new clinical sign in the art of patient examination is also considered for publication. Contributions from anywhere in the world are welcome and considered on their merits.