Ogawa Kiyohisa, Nakamichi Noriaki
Keio University, Shinjuku, Tokyo, Japan.
Am J Orthop (Belle Mead NJ). 2010 Feb;39(2):E15-8.
Tuberculosis of the shoulder is rare and its diagnosis is likely to be delayed because its symptoms often resemble those of the primary frozen shoulder or rotator cuff syndrome. The standard treatment is principally antituberculous chemotherapy plus débridement, if necessary. In this report, we describe 2 patients with advanced shoulder joint tuberculosis that were treated by débridement and closed continuous irrigation and suction using normal saline followed by early range-of-motion exercise with satisfactory results. We emphasize that surgical débridement and closed continuous irrigation and suction, which is one of the standard treatment methods for severe or chronic musculoskeletal infection, should be considered in treating advanced shoulder joint tuberculosis.
肩部结核较为罕见,其诊断往往会被延误,因为其症状常与原发性肩周炎或肩袖综合征相似。标准治疗主要是抗结核化疗,必要时加行清创术。在本报告中,我们描述了2例晚期肩关节结核患者,他们接受了清创术,并用生理盐水进行闭式持续冲洗和吸引,随后早期进行活动度锻炼,结果令人满意。我们强调,手术清创及闭式持续冲洗和吸引作为严重或慢性肌肉骨骼感染的标准治疗方法之一,在治疗晚期肩关节结核时应予以考虑。