Day Michael S, Epstein David M, Young Brett H, Jazrawi Laith M
Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, USA.
Int J Shoulder Surg. 2010 Jul;4(3):83-5. doi: 10.4103/0973-6042.76970.
Mechanical obstacles may infrequently impede closed reduction of anterior shoulder dislocation. Imaging techniques such as arthrography, computed tomography (CT) and magnetic resonance imaging (MRI) complement conventional radiography by allowing identification of obstacles to reduction. We present a case of irreducible anterior glenohumeral dislocation resulting from an initial anterior dislocation, converted to a posterior dislocation with an attempt at reduction, then converted back to anterior dislocation with a second reduction attempt. Soft tissue obstacles to shoulder reduction should be suspected when plain films do not identify a bony fragment as the culprit. CT and MRI are useful for identifying the cause of irreducibility and for operative planning.
机械性障碍可能偶尔会妨碍肩关节前脱位的闭合复位。关节造影、计算机断层扫描（CT）和磁共振成像（MRI）等成像技术通过能够识别复位障碍来补充传统放射学检查。我们报告一例不可复位的肩肱关节前脱位病例，最初为前脱位，在尝试复位时转变为后脱位，然后在第二次复位尝试时又变回前脱位。当X线平片未发现骨碎片为罪魁祸首时，应怀疑存在软组织复位障碍。CT和MRI有助于确定不可复位的原因并用于手术规划。
