Schmal H, Strohm P C, Rosahl S K, Südkamp N P
Department für Orthopädie und Traumatologie, Albert-Ludwigs-Universität, Freiburg.
Unfallchirurg. 2006 Feb;109(2):153-5. doi: 10.1007/s00113-005-0983-3.
Anterior shoulder dislocations are one of the most common problems seen in an emergency department. Doubtless, immediate reduction is necessary for treatment, a procedure that is extremely rarely accompanied by complications. In these cases early diagnosis and treatment may be limb saving. We report a case with rupture of the arteria subscapularis following reduction of an anterior shoulder dislocation with formation of an axillary hematoma and consecutive paresis of the plexus brachialis. Interdisciplinary operative revision was necessary to remove the hematoma, stop the hemorrhage and for neurolysis of the plexus brachialis. Treatment resulted in a speedy recovery of the patient. Gentle reduction of a dislocated shoulder is a prerequisite for a low complication rate. Contrast-enhanced computed tomography facilitated diagnosis of the hematoma and identification of the bleeding vessel.
肩关节前脱位是急诊科最常见的问题之一。毫无疑问，立即复位是治疗的必要手段，该操作极少伴有并发症。在这些病例中，早期诊断和治疗可能挽救肢体。我们报告一例肩关节前脱位复位后肩胛下动脉破裂，形成腋窝血肿并继发臂丛神经麻痹的病例。需要多学科手术翻修以清除血肿、止血并对臂丛神经进行神经松解。治疗使患者迅速康复。轻柔地复位脱位的肩关节是低并发症发生率的前提条件。增强计算机断层扫描有助于血肿的诊断和出血血管的识别。
