Diklic I D, Ganic Z D, Blagojevic Z D, Nho S J, Romeo A A
Belgrade University School of Medicine, Serbia.
J Bone Joint Surg Br. 2010 Jan;92(1):71-6. doi: 10.1302/0301-620X.92B1.22142.
The treatment of a chronic posterior dislocation of the shoulder is often determined by the size of the associated impression fracture of the humeral head. Our hypothesis was that patients with a chronic unreduced posterior dislocation of the shoulder and a defect in the humeral head involving between 25% to 50% of the articular surface, would do better if reconstructed with an allograft from the femoral head rather than treated by a non-anatomical reconstruction. We reviewed ten men and three women with a mean age of 42 years (36 to 51) at a mean follow-up of 54 months (41 to 64) who had this procedure. At follow-up, nine had no pain or restriction of activities of daily living. Their mean Constant-Murley shoulder score was 86.8 (43 to 98). No patient had symptoms of instability of the shoulder. Reconstruction of the defect in the humeral head with an allograft provides good pain relief, stability and function for patients with a locked, chronic posterior dislocation where the defect involves between 25% and 50% of the circumference of the articular surface.
肩关节慢性后脱位的治疗通常取决于肱骨头相关压痕骨折的大小。我们的假设是，对于肩关节慢性未复位后脱位且肱骨头缺损累及关节面25%至50%的患者，采用股骨头同种异体移植重建比非解剖重建治疗效果更好。我们回顾了10名男性和3名女性患者，他们平均年龄42岁（36至51岁），平均随访54个月（41至64个月），均接受了该手术。随访时，9名患者无疼痛或日常生活活动受限。他们的Constant-Murley肩关节平均评分为86.8（43至98）。没有患者出现肩关节不稳定症状。对于关节面缺损累及25%至50%周径的锁定性慢性后脱位患者，采用同种异体移植重建肱骨头缺损可提供良好的疼痛缓解、稳定性和功能。
