三角肌挛缩症术后远期疗效分析

目的:观察手术治疗三角肌挛缩症的远期疗效,录求最佳治疗时机.方法:随访36例49肩术后5年以上患者的畸形矫正,功能恢复情况,并作统计学分析.结果:总优良率85.7%,各年龄组优良率:3～7岁为96.1%,8～12岁为81.3%,12岁以上为57.1%,年龄愈大疗效愈差.结论:早期手术治疗能有效改善症状,阻断病程的进展,提高治疗优良率.     

三角肌挛缩症的手术治疗

目的 :探讨三角肌挛缩的病因及治疗 ,对 1 990年 3月～ 1 998年 1月手术治疗的 1 2例患儿进行分析。方法 :本组男 7例 ,女5例 ;单侧 6例 ,双侧 6例 ;5例肩部接受过肌肉注射 ,其中 2例合并臀肌挛缩。病儿发病年龄均在 1～ 2岁。临床表现为患肩外展畸形 ,内收受限 ,三角肌部皮肤凹陷 ,可扪及硬性条索状物。结果 :全组均经手术治愈 ,术中彻底松解粘连及挛缩组织 ,效果满意。结论 :推测注射性因素可能为主要原因。手术治疗后即可恢复肩关节功能。     

三角肌挛缩症手术治疗年龄与疗效相关性研究

[目的]研究手术治疗三角肌挛缩症年龄与疗效的关系.[方法]对46例(58肩)接受手术病例术前表现及术后3年恢复情况,按年龄组分别统计分析.[结果]年龄越大、症状越重,接受手术时年龄越小症状越好.[结论]三角肌挛缩症一旦诊断确立,应尽早接受手术治疗.     

儿童三角肌挛缩症的误诊误治与治疗分析

目的增强对儿童三角肌挛缩症的认识,探讨其病因、发病机制、诊断和治疗方法.方法 1992年6月～2004年7月,对收治的9例儿童三角肌挛缩症的临床资料进行总结分析,包括病因、临床表现、检查和治疗方法,并随访治疗效果.其中男4例,女5例.年龄5～14岁.结果 9例患儿主要表现为患肩外展畸形、内收障碍、翼状肩胛及三角肌部位凹陷并可扪及质硬的挛缩带.其中4例有三角肌注射史,1例合并臀肌挛缩症.8例确诊前曾被误诊,1例以肩关节陈旧性脱位采用手术误治.均采用挛缩带松解手术治疗, 术后经8个月～12年的随访,除1例遗留轻度翼状肩胛外,余肩外展畸形消失,肩关节活动功能恢复正常.结论儿童三角肌挛缩症可为多因素致病,其特征性临床表现有助于正确的诊断,早期手术治疗效果好.     

三角肌挛缩症的病因探讨

通过对２８例三角肌挛缩症患者的临床及调查资料分析，发现该病非后天致畸因素引起。所有患者表现有共同的特征性症候群，共同的手术所见及病理变化。群体普查中发现，在一家三代中有５例患者，呈现出明显的家庭聚集现象，显示该病的发生与遗传因素有关。１临床及调查资料...     

三角肌挛缩症5例报告

目的：探讨小儿三角肌挛缩症的病因及治疗方法。方法：对本院近10年来收治的小儿三角肌挛缩症5例进行回顾性分析。本组病人就诊时年龄3～6岁，均在l～2岁时发现两侧肩部不对称，进行性加重．除l例外，肩部均有药物注射史。肩关节呈外展姿势，内收受限。X线片表现：肩关节内收位时呈半脱位征，双上肢平行外展位时则无异常。所有病人都采取手术治疗，术中彻底切断松解纤维化的挛缩肌组织，盂肱关节半脱位可自行复位，不需特殊治疗。结果：本组经l～l0年随访，全部病例畸形消失，肩关节功能恢复正常。结论：本病可能是综合性因素所致。一经确诊，即应手术治疗术后早期积极行功能锻炼，效果甚好。     

1例三角肌挛缩患儿误诊分析

儿童三角肌挛缩较为少见,反复的肌肉注射史是最常见的病因,也可以由其他原因所致,如感染或外伤等.三角肌挛缩具有典型的临床表现,如可触及的纤维素条、肩内收受限、翼状肩及挛缩部位皮肤凹陷等,根据这些典型的临床表现一般不难诊断.     

儿童三角肌挛缩症（附15例报告）

儿童三角肌挛缩症较少见，国内文献报告１８例，我科１９９２年１月～１９９７年１２月就收治１５例，现就此病的临床表现、Ｘ线特点、治疗方法、手术所见作一介绍，并对病因进行探讨。１临床资料１．１一般资料本组男９例，女６例，年龄５～１４岁，平均１０岁，发病年龄...     

Long-term result after operative correction of funnel chest

During the last decades it has been commonly accepted that funnel chest is such a serious cosmetic handicap that it deserves correction for this reason alone.     

Treatment of deltoid contracture in adults by distal release of the deltoid

Twenty-five consecutive adult patients (32 shoulders) with deltoid contracture were treated with distal release and followed up for an average of 4 years (range, 2-8 years). All shoulders achieved full range of motion and complete relief of pain and deformity after 3 months. No muscle weakness was clinically evident. In addition, another five adult patients (nine shoulders) with deltoid contracture were treated with distal release and quantitative measurement of muscle power recovery around the shoulder with Cybex 340 dynamometer before surgery, and 3 months and 1 year after surgery. Isokinetic peak torque of shoulder muscles did not decrease significantly at either 60 degrees per second or 180 degrees per second angular velocity after surgery. In addition, the shoulder extensors showed a twofold increase of isokinetic peak torque after surgical release of deltoid contracture. Distal release was a simple and effective surgical technique to treat deltoid contracture in adults. All patients in this series achieved a satisfactory outcome.     

Abduction contracture of the deltoid muscle in children

Summary Deltoid contracture is usually congenital and affects the intermediate part of the muscle. Fibrosis occurring in these fibres produces the contracture. Six patients are reported. Recovery occurred after resection of the fibrotic band.

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Résumé La contracture du deltoïde atteint généralement la partie moyenne du muscle. Les fibres intermédiaires du deltoïde sont bifides et profondément situées. La fibrose au sein de ces fibres musculaires est la cause de la contracture. La résection de la bande fibreuse permet la correction de la déformation de l'epaule et la restauration d'un mécanisme gléno-huméral normal. Notre opinion est que l'éthiologie de ces contractures est congénitale, mais la cause de la fibrose de la portion intermédiaire du deltoïde, reste inexpliquée.

     

A postoperative long-term study of the deltoid contracture in children

Sixty-eight children with contracture of the deltoid muscle (82 shoulders) were treated operatively. These cases showed a minimum angle of 25 degrees of abduction in the resting position. The postoperative course with a minimum follow-up of 5 years was analyzed in 40 cases (49 shoulders). Abduction contracture of the shoulder joint completely disappeared after surgery in 23 shoulders (47%), and winging of the scapula disappeared in 39 shoulders (78%). The angle of horizontal adduction was restored in 14 shoulders (41%) postoperatively. Contracture recurred in only three shoulders (6%).     

Acromial hyperplasia,the sequel of deltoid contracture: A case report

The major complications of deltoid contracture frequently encountered are abduction contracture, winging of the scapula, humeral head flattening and shoulder dislocation (Bhattacharyya 1966; Chatterjee and Gupta 1983). To our knowledge acromium hyperplasia has not been a reported complication of deltoid contracture in the English-language literature. We encountered a patient who had bilateral acromium hyperplasia that appeared to be secondary to deltoid muscle contracture due to large volumes of fluid injected intramuscularly as a child.     

Surgical results of concomitant treatment of deltoid contracture and rotator cuff tear

Background

Contracture of the deltoid muscle is an uncommon disorder. The symptoms usually are nonspecific and the diagnosis may be missed, especially when combined with other shoulder disorders, such as rotator cuff lesions. Few reports have described the surgical treatment of combined deltoid contracture and a torn rotator cuff. The purpose of this study was to share our experiences in the diagnosis and treatment of patients, who sustained deltoid contracture combined with rotator cuff tearing.

Materials and methods

Between April 2001 and December 2006, 18 consecutive patients underwent concomitant treatment for distal release of deltoid contracture and repair of a torn rotator cuff. The mean age at operation was 55.1 years. There were eight female and ten male patients. The acromial type, winging angle of the scapula and thickest diameter of the deltoid fibrotic band were measured using preoperative magnetic resonance imaging studies. The abduction-contracture angle, extension-contracture angle, horizontal-adduction angle and Constant and Murley scores were measured preoperatively and at the latest follow-up.

Results

There were nine complete rotator cuff tears and nine partial tears. At an average of 5 years and 3 months’ follow-up, the mean abduction-contracture angle significantly improved from 27° to 0° (p < 0.001), the mean extension-contracture angle improved from 13° to 0° (p < 0.001), and, the mean horizontal-adduction angle improved from 8° to 44° (p < 0.001). The mean Constant score also improved from 69 points to 95 points (p < 0.001).

Conclusions

If a symptomatic torn rotator cuff and deltoid contracture co-exist, simultaneous operative treatment of both conditions is highly recommended.