Congenital shoulder dislocation
Introduction
Introduction to congenital shoulder dislocation Congenital shoulder dislocation is extremely rare, and only a few cases have been reported in the literature. Only when the shoulder is dislocated at birth is congenital, that is, the dislocation of the diseased joint has formed in the uterus. Clinically seen are often paralyzed, mostly due to paralysis of the shoulder muscles, such as childbirth brachial plexus injury. Traumatic dislocation of the shoulder joint in the neonatal period hardly occurs. basic knowledge The proportion of illness: 0.001% Susceptible people: young children Mode of infection: non-infectious Complications: fracture
Cause
Congenital shoulder dislocation
Neonatal fracture and dislocation often occurs during vaginal delivery, due to malposition of the fetal position or the use of violent birth injury during childbirth. The fracture is more common, often occurs in the clavicle and tibia, followed by femoral fracture, congenital shoulder dislocation in the clinical Less common, it is not caused by human factors, and the exact cause of the disease is currently unclear.
The shoulder joint is dislocated due to congenital absence of bone or surrounding soft tissue, which can occur in the anterior, posterior and posterior directions of the shoulder joint.
Prevention
Congenital shoulder dislocation prevention
The disease is a congenital disease, no effective preventive measures, early diagnosis and early treatment is the key to the prevention and treatment of this disease, but also need to pay attention to the production process, try to reduce the violent actions such as pulling, pulling, sputum, so as not to damage the baby.
Complication
Congenital shoulder dislocation complications Complications
Because the disease is a congenital disease, dislocation is the result of the formation in the fetus, and no other complications are reported, but it will cause dysfunction and skeletal deformity of the child. Therefore, once diagnosed, it is necessary to actively treat it.
Symptom
Congenital shoulder dislocation symptoms Common symptoms Post-shoulder dislocation Shoulder joint mobility limitation Joint deformity Joint swelling Upper limbs are delayed paralysis Scapula soreness
The shape and function of the shoulder joint are limited according to the severity of the deformity. The dysplasia or lack of the shoulder joint or the humeral head can aggravate the deformity. The increase of the shoulder joint instability often involves the upper limb bone deformity.
Examine
Examination of congenital shoulder dislocation
X-ray inspection:
1. Shoulder joint position (front and rear position):
(1) The humeral head has an internal rotation deformity, and no large nodule shadow is visible;
(2) The overlapping of the humeral head and the shoulder blade is reduced or disappeared, the shoulder blade can be completely exposed, and the normal shoulder joint X-ray is on the positive position. The humeral head and the posterior scapula form an overlapping semicircular shadow, and the humeral head joint surface and The images of the leading edge of the scapula are smooth curved curves, and the parallel relationship is broken when the shoulder joint is dislocated;
(3) The distance between the articular surface of the humeral head and the anterior and posterior margin of the scapula is >6 mm.
Because the humeral head dislocation does not move downward, the observation of the anterior slice seems to be good for the joint alignment, and the joint space still exists, so it is easily missed.
2, shoulder joint squat position: in the shoulder joint orthotopic film, if there is suspected dislocation of the shoulder joint, it is best to add the lower iliac crest, the sacral position can clearly show the mutual position relationship between the humeral head and the scapula, humerus Whether the head is displaced and can show the possible combined lesions of the scapula and the humeral head, so the lower projection has the significance of confirming the diagnosis.
Diagnosis
Diagnosis and diagnosis of congenital shoulder dislocation
According to the medical history, clinical manifestations and X-ray film, the disease is not difficult to make a diagnosis.
The main reason for this disease is to identify the dislocation of the shoulder joint caused by the production process at birth.
Neonatal fracture and dislocation often occurs during vaginal delivery. Due to malposition of the fetal position or the use of violent birth injury during childbirth, fractures are more common. If shoulder dislocation occurs, you can check whether there is any pulling, pulling or violent action during operation. And after the child is born, whether the affected shoulder joint has swelling and pressure pain, whether the child has passive crying during passive movement of the shoulder joint, etc. These tests are beneficial to rule out the dislocation of the shoulder caused by birth injury, which is beneficial to identify diagnosis.
