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青少年肩袖外伤性破裂——病例报告

[Traumatic rupture of the rotator cuff in an adolescent--case report].

作者信息

Rickert M, Loew M

机构信息

Sektion für Orthopädie der Schulter und des Ellenbogens, Stiftung Orthopädische Universitätsklinik Heidelberg.

出版信息

Z Orthop Ihre Grenzgeb. 2000 Jul-Aug;138(4):340-3. doi: 10.1055/s-2000-10159.

Abstract

A traumatic rotator cuff tear is a very rare condition, especially in the adolescent. We report about a 14-year-old boy who fell onto the right arm while riding his bicycle. Immediately after the accident he described some kind of click in his right shoulder. he was referred to our institution 3 days after the trauma. The MRI showed a huge defect of the labrumligament complex including the rotator interval. Intraoperatively, we found a complete disruption of the subscapularis and supraspinatus tendons as well as of the anterior stabilizers. We performed a modified Bankart repair and a reconstruction of the ruptured rotator cuff. The patient returned to his former sports as cyclist 3 months after surgery. This case is of clinical relevance because of the traumatic disruption of an intact rotator cuff in a young patient. Not the bone but rather the tendons and ligaments were the weakest link in this situation. In cases of primary traumatic shoulder dislocation, we have to look for bony and soft-tissue damage including the rotator cuff. With the present high standards in ultrasound and MR imaging we have to keep these techniques in mind in order not to overlook this type of accompanying injury.

摘要

创伤性肩袖撕裂是一种非常罕见的病症,尤其是在青少年中。我们报告了一名14岁男孩,他在骑自行车时右臂着地摔倒。事故发生后,他立即感觉右肩部有某种弹响。受伤3天后他被转诊至我院。磁共振成像(MRI)显示盂唇韧带复合体包括旋转间隙有巨大缺损。术中,我们发现肩胛下肌和冈上肌腱以及前部稳定结构完全断裂。我们进行了改良的Bankart修复术和破裂肩袖的重建术。术后3个月,患者恢复了之前作为自行车运动员的运动。该病例具有临床意义,因为年轻患者的完整肩袖发生了创伤性断裂。在这种情况下,薄弱环节不是骨骼,而是肌腱和韧带。在原发性创伤性肩关节脱位的病例中,我们必须寻找包括肩袖在内的骨和软组织损伤。鉴于目前超声和磁共振成像的高标准,我们必须牢记这些技术,以免忽视这类伴随损伤。

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