先天性高肩胛症的手术治疗

Surgical Treatment of Congenital Elevated Scapula

介绍和评价Ｗｏｏｄｗａｒｄ手术治疗先天性高肩胛症的情况，讨论２例发生臂丛神经损伤的教训。全组手术３０例，男１２例，女１８例，术时年龄３～９岁１９例，１１～１４岁１１例。单纯先天性高肩肿症８例，伴有先天性脊柱侧凸者２２例。２例术后出现臂丛神经损伤，经松解而恢复。１４例同时做了锁骨粉碎术。所有病例均做了肩胛下移，达到外形改善。肩的外展功能大部分病例有所提高。Ｗｏｏｄｗａｒｄ手术治疗先天性高肩肿症与其他手术比较创伤小，出血少，操作简便，效果好。锁骨粉碎术有预防臂丛神经损伤的作用。

Thirty children (male. 12 , female 18 ) with congenital elevated scapula treated by Woodward procedure are reported. Nineteen cases were between 3～ 9 years of age and the rest were 11 ～l4. Eight cases were simple elevation of the scapule , and 22 cases complicated by con- genital scoliosis. They all were treated by instrumentation and bony fusion through the same incision. Two of them had brachial plexus injuries and recovered after neurolysis and the elevated scapula were reduced in certain degree but the improvement of shoulder function was not certain. It is concluded that Woodward procedure is simple and efficient with less trauma and hemorrhage . Additional clavicle morcellation may be good to avoid the injury of brachial plexus .