Li Hao-Huan, Liu Shi-Qing, Peng Hao
Department of Orthopedics, Renmin Hospital of Wuhan University, Wuhan, Hubei, People's Republic of China.
J Emerg Med. 2011 Aug;41(2):154-6. doi: 10.1016/j.jemermed.2008.01.031. Epub 2008 Oct 18.
Cases of posterior dislocation or fracture-dislocation of the shoulder are rare. A combination of posterior dislocation and ipsilateral humeral shaft fracture, especially a distal third one, is even rarer. In such injuries, the diagnosis of shoulder dislocation may be missed because great attention is usually given to the fractured humerus.
We present this case report to raise awareness among emergency physicians of this manner of injury.
We present a case report of a 30-year-old woman who had posterior fracture dislocation of the right shoulder with ipsilateral distal humeral shaft fracture. The shaft fracture was initially evaluated, internally reduced, and fixed, whereas the posterior fracture-dislocation of the shoulder was not recognized. A belated diagnosis was established 1 month after the operation, when a computed tomography scan was performed because the patient reported continuous pain and limited range of motion of the shoulder. A second reduction was performed to reduce the dislocation. The patient had partial functional recovery 1 year later.
Consideration of this condition, coupled with thorough and appropriate physical and radiological examinations, could lead to improved recognition of such cases.
肩关节后脱位或骨折 - 脱位病例罕见。肩关节后脱位与同侧肱骨干骨折，尤其是肱骨干远端三分之一骨折同时发生的情况更为罕见。在此类损伤中，由于通常会高度关注骨折的肱骨，肩关节脱位可能会被漏诊。
我们通过本病例报告提高急诊医生对此类损伤方式的认识。
我们报告一例30岁女性患者，其右肩关节后骨折脱位并伴有同侧肱骨干远端骨折。最初对肱骨干骨折进行了评估、切开复位内固定，而肩关节后骨折脱位未被识别。术后1个月，因患者自述肩部持续疼痛且活动范围受限，行计算机断层扫描后才确诊。随后进行了二次复位以纠正脱位。1年后患者功能部分恢复。
考虑到这种情况，并结合全面且恰当的体格检查和影像学检查，有助于提高对此类病例的识别。
