AIM: To systematically review and analyze the overall impact and effectiveness of bony surgical procedures, the triangle tilt and humeral surgery in a comparative manner in permanent obstetric brachial plexus injury(O...AIM: To systematically review and analyze the overall impact and effectiveness of bony surgical procedures, the triangle tilt and humeral surgery in a comparative manner in permanent obstetric brachial plexus injury(OBPI) patients.METHODS: We conducted a literature search and identified original full research articles of OBPI patients treated with a secondary bony surgery, particularly addressing the limitation of shoulder abduction and functions. Further, we analyzed and compared the efficacy and the surgical outcomes of 9 humeral surgerypapers with 179 patients, and 4 of our secondary bony procedure, the triangle tilt surgical papers with 86 patients. RESULTS: Seven hundred and thirty-one articles were identified, using the search term "brachial plexus" and obstetric or pediatric(246 articles) or neonatal(219 articles) or congenital(188 articles) or "birth palsy"(121 articles). Further, only a few articles were identified using the bony surgery search, osteotomy "brachial plexus" obstetric(35), "humeral osteotomy" and "brachial plexus"(17), and triangle tilt "brachial plexus"(14). Of all, 12 studies reporting pre- and postoperative or improvement in total Mallet functional score were included in this study. Among these, 9 studies reported the humeral surgery and 4 were triangle tilt surgery. We used modified total Mallet functional score in this analysis. Various studies with humeral surgery showed improvement of 1.4, 2.3, 5.0 and 5.6 total Mallet score, whereas the triangle tilt surgery showed improvement of 5.0, 5.5, 6.0 and 6.2.CONCLUSION: The triangle tilt surgery improves on what was achieved by humeral osteotomy in the management of shoulder function in OBPI patients.展开更多
目的观察电针联合手牵足蹬手法复位对初次肩关节脱位患者肩关节功能的影响。方法将78例初次肩关节脱位的患者,随机分为对照组和观察组,每组39例。对照组采用手牵足蹬法复位进行治疗,观察组在对照组的基础上联合电针治疗。观察两组治疗前...目的观察电针联合手牵足蹬手法复位对初次肩关节脱位患者肩关节功能的影响。方法将78例初次肩关节脱位的患者,随机分为对照组和观察组,每组39例。对照组采用手牵足蹬法复位进行治疗,观察组在对照组的基础上联合电针治疗。观察两组治疗前后Neer肩关节功能评分、Rowe氏评分系统中稳定性及活动度评分、肩关节角度及治疗前、出院时和出院后1个月疼痛视觉模拟量表(visual analog scale,VAS)评分变化,并比较两组不良反应发生率。结果治疗后,两组Neer肩关节功能评分各项评分及总分均升高(P<0.05),且观察组疼痛和运动范围评分及总分高于对照组(P<0.05);两组Rowe氏评分中的稳定性和活动度评分均升高(P<0.05),且观察组高于对照组(P<0.05);两组前屈上举、外展外旋角度均增大(P<0.05),且观察组大于对照组(P<0.05),两组体侧外旋角度比较差异无统计学意义(P>0.05)。两组出院时、出院后1个月VAS评分均低于治疗前,且观察组出院时、出院后1个月VAS评分均低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论针刺联合手牵足蹬手法复位可改善初次肩关节脱位患者的肩关节功能及疼痛情况,无明显不良反应,是一种安全、有效的治疗方法。展开更多
文摘AIM: To systematically review and analyze the overall impact and effectiveness of bony surgical procedures, the triangle tilt and humeral surgery in a comparative manner in permanent obstetric brachial plexus injury(OBPI) patients.METHODS: We conducted a literature search and identified original full research articles of OBPI patients treated with a secondary bony surgery, particularly addressing the limitation of shoulder abduction and functions. Further, we analyzed and compared the efficacy and the surgical outcomes of 9 humeral surgerypapers with 179 patients, and 4 of our secondary bony procedure, the triangle tilt surgical papers with 86 patients. RESULTS: Seven hundred and thirty-one articles were identified, using the search term "brachial plexus" and obstetric or pediatric(246 articles) or neonatal(219 articles) or congenital(188 articles) or "birth palsy"(121 articles). Further, only a few articles were identified using the bony surgery search, osteotomy "brachial plexus" obstetric(35), "humeral osteotomy" and "brachial plexus"(17), and triangle tilt "brachial plexus"(14). Of all, 12 studies reporting pre- and postoperative or improvement in total Mallet functional score were included in this study. Among these, 9 studies reported the humeral surgery and 4 were triangle tilt surgery. We used modified total Mallet functional score in this analysis. Various studies with humeral surgery showed improvement of 1.4, 2.3, 5.0 and 5.6 total Mallet score, whereas the triangle tilt surgery showed improvement of 5.0, 5.5, 6.0 and 6.2.CONCLUSION: The triangle tilt surgery improves on what was achieved by humeral osteotomy in the management of shoulder function in OBPI patients.
文摘目的观察电针联合手牵足蹬手法复位对初次肩关节脱位患者肩关节功能的影响。方法将78例初次肩关节脱位的患者,随机分为对照组和观察组,每组39例。对照组采用手牵足蹬法复位进行治疗,观察组在对照组的基础上联合电针治疗。观察两组治疗前后Neer肩关节功能评分、Rowe氏评分系统中稳定性及活动度评分、肩关节角度及治疗前、出院时和出院后1个月疼痛视觉模拟量表(visual analog scale,VAS)评分变化,并比较两组不良反应发生率。结果治疗后,两组Neer肩关节功能评分各项评分及总分均升高(P<0.05),且观察组疼痛和运动范围评分及总分高于对照组(P<0.05);两组Rowe氏评分中的稳定性和活动度评分均升高(P<0.05),且观察组高于对照组(P<0.05);两组前屈上举、外展外旋角度均增大(P<0.05),且观察组大于对照组(P<0.05),两组体侧外旋角度比较差异无统计学意义(P>0.05)。两组出院时、出院后1个月VAS评分均低于治疗前,且观察组出院时、出院后1个月VAS评分均低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论针刺联合手牵足蹬手法复位可改善初次肩关节脱位患者的肩关节功能及疼痛情况,无明显不良反应,是一种安全、有效的治疗方法。
