Cunningham G, Hoffmeyer P
Service de chirurgie orthopédique et traumatologie de l'appareil moteur, HUG, 1211 Genève 14.
Rev Med Suisse. 2011 Dec 21;7(322):2489-93.
Posterior glenohumeral dislocation is rare, accounting for less than 3% of all shoulder dislocations. Main etiologies are direct or indirect trauma, seizure and electrocution. The diagnosis is missed in 50 to 80% of the cases on initial presentation because of the rather subtle clinical signs compared to anterior dislocation and inadequate imaging. An unreduced posterior dislocation can lead to severely impairing complications such as recurrent instability, arthritis or avascular necrosis, requiring open reduction and complex surgery with a lower rate of success. The purpose of this article is to highlight and clarify the challenges when confronted with posterior dislocation in order to avoid misdiagnosis. Furthermore it aims to propose an adequate and comprehensible management from the initial diagnosis to the treatment.
肩后脱位较为罕见，占所有肩关节脱位的比例不到3%。主要病因是直接或间接创伤、癫痫发作和触电。由于与前脱位相比临床体征较为隐匿且影像学检查不充分，50%至80%的病例在初次就诊时漏诊。未复位的后脱位可导致严重的并发症，如复发性不稳定、关节炎或缺血性坏死，需要切开复位及复杂手术，成功率较低。本文旨在强调并阐明面对后脱位时的挑战，以避免误诊。此外，其目的是从初始诊断到治疗提出适当且易于理解的处理方法。
