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:探讨两种微创钢板内固定术(minimally invasive plate osteosynthesis,MIPO)治疗肱骨干近端骨折的临床效果。方法:选取2020年6月—2022年6月瓮安县人民医院收治的82例肱骨干近端骨折患者为研究对象。按随机数表法将患者分为两组,...目的:探讨两种微创钢板内固定术(minimally invasive plate osteosynthesis,MIPO)治疗肱骨干近端骨折的临床效果。方法:选取2020年6月—2022年6月瓮安县人民医院收治的82例肱骨干近端骨折患者为研究对象。按随机数表法将患者分为两组,各41例。对照组行肱骨外侧入路MIPO术治疗,观察组行螺旋MIPO术治疗。比较两组手术情况、疼痛评分、肩关节功能、肩关节活动度及并发症发生情况。结果:观察组手术时间较对照组长,骨折愈合时间较对照组早,差异有统计学意义(P<0.05)。两组术后1 d、3 d、7 d的视觉模拟评分法(visual analogue scale,VAS)评分相比,差异无统计学意义(P>0.05)。两组术后Constant肩关节评分、美国肩与肘外科协会评分系统(American Shoulder and Elbow Surgeon'form,ASES)评分、美国加州大学肩关节评分系统(the University of California at Los Angeles shoulder rating scale,UCLA)评分高于术前,差异有统计学意义(P<0.05);两组术后Constant肩关节评分、ASES评分、UCLA评分相比,差异无统计学意义(P>0.05)。两组术后肩关节前屈、外旋活动度均高于术前,差异有统计学意义(P<0.05);两组术后肩关节前屈、外旋活动度相比,差异无统计学意义(P>0.05)。观察组并发症发生率较对照组低,差异有统计学意义(P<0.05)。结论:两种MIPO治疗肱骨干近端骨折均可取得较好效果,可加快肩关节功能恢复,而螺旋MIPO术骨折愈合更快,术后并发症更少。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:探讨两种微创钢板内固定术(minimally invasive plate osteosynthesis,MIPO)治疗肱骨干近端骨折的临床效果。方法:选取2020年6月—2022年6月瓮安县人民医院收治的82例肱骨干近端骨折患者为研究对象。按随机数表法将患者分为两组,各41例。对照组行肱骨外侧入路MIPO术治疗,观察组行螺旋MIPO术治疗。比较两组手术情况、疼痛评分、肩关节功能、肩关节活动度及并发症发生情况。结果:观察组手术时间较对照组长,骨折愈合时间较对照组早,差异有统计学意义(P<0.05)。两组术后1 d、3 d、7 d的视觉模拟评分法(visual analogue scale,VAS)评分相比,差异无统计学意义(P>0.05)。两组术后Constant肩关节评分、美国肩与肘外科协会评分系统(American Shoulder and Elbow Surgeon'form,ASES)评分、美国加州大学肩关节评分系统(the University of California at Los Angeles shoulder rating scale,UCLA)评分高于术前,差异有统计学意义(P<0.05);两组术后Constant肩关节评分、ASES评分、UCLA评分相比,差异无统计学意义(P>0.05)。两组术后肩关节前屈、外旋活动度均高于术前,差异有统计学意义(P<0.05);两组术后肩关节前屈、外旋活动度相比,差异无统计学意义(P>0.05)。观察组并发症发生率较对照组低,差异有统计学意义(P<0.05)。结论:两种MIPO治疗肱骨干近端骨折均可取得较好效果,可加快肩关节功能恢复,而螺旋MIPO术骨折愈合更快,术后并发症更少。
