Liodakis E, Kenawey M, Petri M, Liodaki E, Hankemeier S, Krettek C, Jagodzinski M
Unfallchirurgische Klinik, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.
Unfallchirurg. 2011 Jun;114(6):532-7. doi: 10.1007/s00113-010-1818-4.
Acromial fractures are rare but severe complications which can occur during subacromial decompression. We report a case of acromial pseudarthrosis which was discovered belatedly due to persistent pain after several operations. The pseudarthrosis was successfully treated by osteosynthesis with a distal radius plate and implantation of a monocortical bone graft from the iliac crest. Two years after surgery, the fracture has healed and the patient's pain improved significantly. In the constant score the patient achieved postoperatively 58 points compared to 25 points before surgery and 65 points compared to 25 points preoperatively in the subjective shoulder rating system (SSRS). Postoperatively, the patient had a better range of motion with active abduction/adduction of 50/0/25º (30/0/20° preoperatively), outward rotation/inward rotation of 35/0/45º (30/0/30° preoperatively) and anteversion/retroversion of 60/0/35° (35/0/20° preoperatively).
肩峰骨折虽罕见,但在肩峰下减压手术过程中可能会出现严重并发症。我们报告一例肩峰假关节病例,该病例因多次手术后持续疼痛而被延误发现。通过使用桡骨远端钢板进行骨固定术并植入取自髂嵴的单皮质骨移植片,成功治疗了该假关节。术后两年,骨折愈合,患者疼痛明显改善。在Constant评分中,患者术后得58分,术前为25分;在主观肩关节评分系统(SSRS)中,术后得65分,术前为25分。术后,患者活动范围改善,主动外展/内收为50/0/25°(术前为30/0/20°),外旋/内旋为35/0/45°(术前为30/0/30°),前倾角/后倾角为60/0/35°(术前为35/0/20°)。