スプレンゲル変形に対する肩甲骨骨切り術 −至適手術年齢の検討−

概要

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Wilkinsons scapular osteotomy for Sprengels shoulder has been historically performed on patients after the age of 5. We have been trying this procedure in younger children because we believe that early gain of scapula mobility is important to obtain more normalized clinical results. The subjects were 9 shoulders in 8 patients with a mean age of 5.7 years old (range, 3.3-11.2 years old) at the time of operation. The mean follow-up term was 5.5 years. The operation time, the amount of blood lost, the scapula height on plain radiographs, the cosmetic grade (Cavendish) and the range of motion before and after the operation were investigated. The final results in the younger age group (Group A), in which osteotomy was performed before the age of 5, was compared with those in the older age group (Group B). There were no statistical differences in operation time, the amount of blood loss, the cosmetic grade (Cavendish) between the 2 groups. The mean maximum active abduction at the final follow-up was higher in Group A than that in Group B, although there was no statistically significant difference. Improvement of the scapula height on plain radiographs after the operation in Group A was significantly better than that in Group B. We concluded that a scapular osteotomy could be safely done at the age of 3 or 4 and an osteotomy at a younger age could provide a better result.
日本肩関節学会の論文