Cyffka R, Jackisch Th, Lein Th, Bonnaire F
Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Klinikum Dresden.
Unfallchirurg. 2005 Apr;108(4):327-31. doi: 10.1007/s00113-004-0878-8.
We report about a 29 year old male patient who had a simultaneous bilateral ventral and dorsal shoulder dislocation. The dislocation happened during a first incident of an epileptic convulsion, previously not diagnosed. On the right shoulder following a closed reduction manoeuvre a dislocation fracture was seen. It needed operative open reduction and fixation with angular stable plate osteosynthesis. The locked dorsal shoulder dislocation on the left was operated dorsally secondary via a dorsal approach. In a first step the reduction was carried out and in the same intervention the humeral head defect was lifted and supported in a closed technique under radiographic control.6 months postoperatively the patient was free of pain in both shoulder joints. The range of motion was unimpeded on the left and only with slight deficits in abduction and anteversion on the right. The diagnostics and the treatment strategy for this rare injury combination are described critically in this paper.
我们报告了一例29岁男性患者，其双侧肩部同时发生腹侧和背侧脱位。脱位发生在首次癫痫发作期间，此前未被诊断出患有癫痫。右侧肩部在进行闭合复位操作后出现了脱位骨折。这需要进行手术切开复位并用角稳定钢板进行骨合成固定。左侧锁定的背侧肩关节脱位通过背侧入路进行二期手术。第一步进行复位，在同一手术中，在X线透视控制下，采用闭合技术抬起并支撑肱骨头缺损处。术后6个月，患者双侧肩关节均无疼痛。左侧肩关节活动范围不受限，右侧仅在外展和前屈时有轻微受限。本文对这种罕见损伤组合的诊断和治疗策略进行了批判性描述。
