Sharma L, Pankaj A, Kumar V, Malhotra R, Bhan S
Department of Orthopaedics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
J Orthop Surg (Hong Kong). 2005 Dec;13(3):303-6. doi: 10.1177/230949900501300316.
Bilateral simultaneous anterior dislocation of the shoulders with bilateral 3-part fracture of the proximal humeri is unusual. A 42-year-old man presented with pain and restriction of movement on both shoulders. He was injured by a heavy object falling over his back while he was leaning forward holding an overhead bar. His arms were abducted and externally rotated. The injury was not correctly diagnosed, and the patient was treated with repeated manipulations and splintage for 2 weeks. Radiological examination revealed bilateral anterior dislocation of the shoulders with displaced 3-part fractures of the proximal humeri involving the shaft, greater tuberosity, and head. The patient was treated with open reduction and internal fixation through a deltopectoral approach using multiple Kirschner wires. The shoulders were kept immobilised for 3 weeks until the removal of the wires. The patient was able to resume work 3 months after surgery. He had an excellent and comfortable range of motion in both shoulders at one-year follow-up.
双侧肩关节同时前脱位并伴有双侧肱骨近端三部分骨折的情况较为罕见。一名42岁男性因双肩疼痛及活动受限前来就诊。他在向前倾身抓住头顶横杆时,被重物砸落在背部而受伤。其双臂处于外展及外旋状态。该损伤最初未被正确诊断,患者接受了反复手法复位及夹板固定治疗两周。影像学检查显示双侧肩关节前脱位,伴有肱骨近端移位的三部分骨折,累及骨干、大结节及肱骨头。患者通过经三角肌胸大肌入路,使用多根克氏针进行切开复位内固定治疗。肩部固定3周直至取出克氏针。患者术后3个月能够恢复工作。在一年随访时,他双肩的活动范围极佳且舒适。