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Die Schulterluxation beim Neugeborenen

Bericht über 12 Fälle und Literaturübersicht

Shoulder dislocation in the newborn

Report of 12 cases and review of the literature

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Zusammenfassung

Schulterluxationen des Neugeborenen sind selten. Bisher gibt es kein einheitliches Therapiekonzept. Diese retrospektive klinische Studie (1967–2003) schließt 9 Neugeborene mit 12 betroffenen Schultergelenken ein. Bei der Datenerhebung wurde insbesondere Therapie und -erfolg erfasst. Mit einem Fragebogen wurde die Gelenkstellung und dessen Funktionalität bestimmt. Publikationen von 1904–2003 wurden überarbeitet und dienten zum Vergleich.

Errechnete 0,018–0,07% der Neugeborenen haben eine Schulterluxation. Die Diagnose wurde durchschnittlich im Alter von 22 Tagen gestellt. Unser Patientenkollektiv umfasst je 4 kongenitale und paralytische, sowie je 2 spastische und traumatische Schulterluxationen. Alle wurden initial konservativ behandelt. Ein Patient wurde bei ungenügendem Erfolg operiert. Im durchschnittlichen Nachbeobachtungszeitraum von 19,4 Jahren konnte keine Reluxation festgestellt werden. Alle empfanden die Schulterfunktion als alltagstauglich.

Wir empfehlen primär eine konservative Therapie. Ein chirurgisches Vorgehen sollte nur bei Versagen der konservativen Therapie in Betracht gezogen werden.

Abstract

Shoulder dislocation in the newborn is a rare entity. Therefore, a therapeutic regimen does not exist.

This retrospective clinical study (1967–2003) includes 9 newborns with 12 dislocations of the shoulder. The data focus in particular on the therapeutic strategy and its success. The position of the joint and its functionality were monitored with a questionnaire. Publications from 1904 to 2003 were reviewed and served for comparison.

Results of calculations showed that 0.018–0.07% of newborns suffer from shoulder dislocations. The diagnosis was made on average at the age of 22 days. Our data include four cases each of congenital and paralytic and two cases each of spastic and traumatic shoulder dislocations. All of them were initially treated conservatively, but because of inadequate results one patient finally had to be operated. In the follow-up of 19.4 years, none of them developed a redislocation and all shoulder functions were suitable for daily life.

We propose that patients primarily be treated conservatively; however, if therapy fails, surgery has to be performed.

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Authors and Affiliations

  1. Sektion für Kinderorthopädie und Wirbelsäulenchirurgie, Orthopädische Klinik, Universität, Heidelberg

    N. Schmelzer-Schmied, B. G. Ochs &  C. Carstens

  2. Sektion für Kinderorthopädie und Wirbelsäulenchirurgie, Orthopädische Klinik, Universität, Schlierbacher Landstraße 200a, 69118, Heidelberg

    C. Carstens

Authors
  1. N. Schmelzer-Schmied
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  2. B. G. Ochs
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  3. C. Carstens
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Correspondence to C. Carstens.

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Schmelzer-Schmied, N., Ochs, B.G. & Carstens, C. Die Schulterluxation beim Neugeborenen. Orthopäde 34, 454–461 (2005). https://doi.org/10.1007/s00132-005-0775-z

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  • DOI: https://doi.org/10.1007/s00132-005-0775-z

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