頁籤選單縮合
題名 | Changes Around the Shoulder Girdle in Deltoid Contracture= |
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作者 | 郭繼陽; 王清貞; Ko, Jih-yang; Wang, Ching-jen; |
期刊 | 中華民國骨科醫學會雜誌 |
出版日期 | 19981200 |
卷期 | 15:4 1998.12[民87.12] |
頁次 | 頁137-142 |
分類號 | 416.64 |
語文 | eng |
關鍵詞 | Deltoid contracture; Bony changes; |
英文摘要 | From February 1989 to December 1994, 40 patients (49 shoulders) received distal release for deltoid contracture. The average age of operation was 39 years (range, 15 to 63 years). The right shoulder was involved in 21 and the left shoulder n 29. Besides physical examination, chest PA, anteropostenior and scapular Y views of the shoulders were made in all patients. Axial view, arthrogram, CT or MRI were made in selected cases. AT an average follow-up of 3 years and 11 months, winging of the scapula resolved completely in 39 patients (48 shoulders; 98%) and only partially in one patient. Of the eight patients who had had the deltoid contracture before 16 years old, five had evidencd of rotation of the scapula, which became unnoticed after surgical releases. Anterosuperior subluxation of the humeral head was noted in 23 shoulders which disappeared after surgical releases. Two patients had recurrent anterior dislocation of the shoulder. Drooping of the acromion was noted in six patients; and the drooping had improved in five. A mechanism between the changes of shoulder girdle and the deltoid contracture was proposed. Surgical releases correctec almost all of the bony changes around the shoulder due to prolonged deltoid contracture. However, prolonged anterior subluxation may stretch the anterior capsuloligamentous complex and induce or aggravate the incidence of recurrent anterior dislocation, leading to functional instability. Persistent acromial drooping after release might potentiate the incidence of rotator cuff attrition. |
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