一例被忽视的肩关节后方骨折脱位病例:大结节截骨术

IF 0.4 Q4 ORTHOPEDICS Case Reports in Orthopedics Pub Date : 2024-06-11 eCollection Date: 2024-01-01 DOI:10.1155/2024/6486750
Masashi Koide, Satoshi Tateda, Sayaka Miyasaka, Akihiro Yasuyama, Yoichi Sasaki, Mika Abe
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引用次数: 0

摘要

肩关节后脱位是一种罕见病。与肩关节前脱位相比,它缺乏明显的临床特征,而且放射学检查也不恰当,因此常常被误诊。我们介绍了一例通过大结节截骨术治疗的慢性后方骨折脱位病例。一名 66 岁的男子在携带无人机时不慎摔伤。他在附近一家诊所接受了 3 个月的保守治疗,但后脱位仍未复位,于是被转诊到我院。体格检查显示肩关节活动范围明显缩小,肩部疼痛。放射学检查显示,肩关节后脱位伴有大结节错位和盂后部小骨骨折。患者接受了切开复位和内固定术,包括大结节截骨术。虽然术后仍存在后脱位,但由于肩袖力量的耦合作用,肱骨头逐渐恢复到肩关节的中心位置。在24个月的随访中,患者的肩关节效果非常好。
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A Case of Neglected Posterior Fracture Dislocation of the Shoulder Treated With Greater Tuberosity Osteotomy.

Posterior dislocation of the shoulder joint is a rare condition. It is often misdiagnosed owing to a lack of evident clinical features compared with anterior shoulder dislocation, and inappropriate radiological examination. We present a case of chronic posterior fracture dislocation treated with greater tuberosity osteotomy. A 66-year-old man was injured in a fall while carrying a drone. He was referred to our hospital following 3 months of conservative treatment at a nearby clinic, without reduction of the posterior dislocation. Physical examination revealed a prominent reduction in shoulder joint range of motion and shoulder pain. Radiological examination revealed posterior shoulder dislocation associated with greater tuberosity malunion and a small bone fracture of the posterior portion of the glenoid. Open reduction and internal fixation, including greater tuberosity osteotomy, were performed. Although subluxation of the posterior dislocation persisted postoperatively, the humeral head gradually returned to its centric shoulder joint position owing to rotator cuff force coupling. At 24-month follow-up, the patient showed excellent shoulder results.

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审稿时长
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