Key result
Shoulder dysfunction in children with obstetric brachial plexus palsy was caused by antagonist muscle or joint capsule contracture in 38 of 40 cases, rather than agonist weakness.
In children with obstetric brachial plexus palsy, shoulder dysfunction is primarily caused by contracture of antagonist muscles or the joint capsule due to asynchronous nerve recovery, highlighting the need for early diagnosis.
May support contracture-focused assessment in obstetric brachial plexus palsy; hypothesis-generating case report requiring prospective validation.
目的:对产瘫患儿肩关节功能作定量和定性检查,以明确肩关节功能障碍是因主动肌的无力抑或是拮抗肌和关节囊的挛缩所致.方法:对40例肩关节功能障碍而肱二头肌肌力达M3以上的产瘫患儿,采用Mallet评分,Gilbert分级,盂肱角测量,肩关节中立位被动外旋,翼状肩胛检查,肌电图及X线诊断等检查手段,综合评价其肩关节功能.结果:38例肩关节功能障碍是由于拮抗肌或关节囊挛缩引起,其中内旋挛缩35例(合并肩关节后关节囊挛缩14例),肩关节下部挛缩3例.另2例肩外展不能是因主动肌无力所致.结论:产瘫患儿有较好的但不同步的神经恢复是产生各种肩关节挛缩后遗症的主要原因.早期诊断有助于及时治疗和预防肩关节继发性病变的发生.
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Li et al. (1997) studied this question. Shoulder dysfunction in children with obstetric brachial plexus palsy was caused by antagonist muscle or joint capsule contracture in 38 of 40 cases, rather than agonist weakness.
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