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目的：对产瘫患儿肩关节功能作定量和定性检查，以明确肩关节功能障碍是因主动肌的无力抑或是拮抗肌和关节囊的挛缩所致。方法：对４０例肩关节功能障碍而肱二头肌肌力达Ｍ３以上的产瘫患儿，采用Ｍａｌｅｔ评分，Ｇｉｌｂｅｒｔ分级，盂肱角测量，肩关节中立位被动外旋，翼状肩胛检查，肌电图及Ｘ线诊断等检查手段，综合评价其肩关节功能。结果：３８例肩关节功能障碍是由于拮抗肌或关节囊挛缩引起，其中内旋挛缩３５例（合并肩关节后关节囊挛缩１４例），肩关节下部挛缩３例。另２例肩外展不能是因主动肌无力所致。结论：产瘫患儿有较好的但不同步的神经恢复是产生各种肩关节挛缩后遗症的主要原因。早期诊断有助于及时治疗和预防肩关节继发性病变的发生
OBJECTIVE: To quantitative and qualitative examination of shoulder joint function in children with paraplegia in order to find out that shoulder joint dysfunction is caused by weakness of active muscle or contracture of antagonistic muscle and joint capsule. Methods: Forty pediatric patients with paraplegia who had muscular strength of M3 or more with shoulder dysfunction were treated with Malet score, Gilbert classification, glenohumeral angle measurement, passive external rotation of shoulder joint, wing-like scapular examination, Electrogram and X-ray diagnosis and other inspection methods, comprehensive evaluation of the shoulder joint function. RESULTS: Thirty-eight patients with shoulder dysfunction were caused by antagonistic muscle or capsular contracture. Among them, 35 cases were contracture of internal rotation contracture (contracture of joint capsule in 14 cases) and 3 cases of contracture in lower part of shoulder joint. The other 2 cases of shoulder abduction can not be due to active muscle weakness. CONCLUSIONS: Better but not synchronized neurological recovery in children with paraplegia is the major cause of various sequelae of shoulder contracture. Early diagnosis helps to timely treat and prevent the occurrence of secondary shoulder joint disease