Neurogenic lesions after posterolateral thoracotomy in young children
| Autor: | Haupt Wf, Dalichau H, Mennicken U, Herse B, Schumann D, Emmel M, Ulbach P |
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| Rok vydání: | 1996 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Shoulder Posture Coarctation of the aorta Axillary lines First year of life Aortic Coarctation Scapula Upward displacement Peripheral Nerve Injuries Medicine Humans Range of Motion Articular Posterolateral thoracotomy Child Rest (music) Anthropometry business.industry Electromyography Age Factors Infant medicine.disease Surgery Paresis medicine.anatomical_structure Thoracotomy Shoulder girdle Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | The Thoracic and cardiovascular surgeon. 44(2) |
| ISSN: | 0171-6425 |
| Popis: | In follow-up examinations of young patients we often noticed upward displacement of the left shoulder in cases where left-sided posterolateral thoracotomy had been carried out. Finding little discussion of this side-effect in the literature, we undertook the present study. The shoulder girdle of 69 patients who had undergone surgery for coarctation of the aorta between 1964 and 1984 was carefully examined to assess displacements and dysfunctions. In addition, in 24 of the patients electrodiagnostic examination was carried out of the associated muscles and nerves which were affected by the operation. We found disturbances of the muscular apparatus of the shoulder girdle in 80% of the cases: upward displacement of the shoulder (55%), downward displacement of the shoulder (8.7%), deviation of the scapula at rest (72.5%) and maximal elevated arms (40.6%), scapula alata (56.5%), and alterations of the posterior axillary line (39.1%). When considering only the cases of distinct upward or downward displacement of the shoulder, at least 25% of the operated children were affected. Children operated early (surgery during the first year of life) had more distinct alterations (47.6%) than those with later surgery (14.6%). Electromyographic examinations indicate that mainly disorders of the peripheral nerves caused by the operation led to these alterations of the shoulder girdle musculature. Although, except for one patient, no functional disorders were found, there were several cases in which the alteration caused quite severe cosmetic problems. One should pay more attention to positioning for surgery and do careful preparation to reduce these sequelae. |
| Databáze: | OpenAIRE |
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