Matsuzaki Tokio, Kokubu Takeshi, Nagura Issei, Toyokawa Narikazu, Inui Atsuyuki, Fujioka Hiroyuki, Doita Minoru, Kurosaka Masahiro
Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Japan.
Kobe J Med Sci. 2009 Mar 10;54(5):E237-40.
An 83-year-old woman, subsequently diagnosed with Parkinson's disease, fell on her right shoulder. Radiographs showed the humeral head dislocated anterosuperiorly. The supraspinatus tendon was massively disrupted and judged irreparable. The subscapularis tendon was repaired, however re-dislocation of the humeral head was confirmed after the surgery but further treatment was rejected as she was almost pain free and had a low activity level. The patient was followed up for one year after surgery and her shoulder became almost pain-free, but range of motion with active elevation was limited. In such cases a goal of absence or reduction of pain rather than real repair might be considered appropriate.
一名83岁女性，随后被诊断患有帕金森病，右肩部着地摔倒。X线片显示肱骨头向前上方脱位。冈上肌腱严重断裂，判定无法修复。肩胛下肌腱进行了修复，但术后证实肱骨头再次脱位，不过由于她几乎没有疼痛且活动水平较低，拒绝了进一步治疗。术后对该患者进行了一年的随访，其肩部几乎无疼痛，但主动抬高的活动范围受限。在这种情况下，或许可以认为以消除或减轻疼痛而非真正修复为目标是合适的。
