Jansen Hendrik, Frey Sönke P, Doht Stefanie, Meffert Rainer H
University Clinics Würzburg, Wuerzburg, Germany
University Clinics Würzburg, Wuerzburg, Germany.
J Surg Case Rep. 2012 Dec 4;2012(11):rjs017. doi: 10.1093/jscr/rjs017.
Shoulder dislocations with fractures are a possible complication of an epileptic seizure and are often missed on the first sight. The incidence of sustaining an avascular humeral head necrosis (AVN) is high, and primary prosthetic replacement is the choice of treatment. In this paper, we describe such a rare case: a 48-year-old male patient sustained simultaneous bilateral posterior shoulder dislocation with fractures of both humeral heads following the first episode of an epileptic convulsion. On the left side, open reduction and internal fixation were performed with angle stable plate osteosynthesis. In the same operation, a hemi-prosthesis was implanted on the right side. One and a half years postoperatively, function on the right side is unsatisfying and AVN is seen on the left side and secondary prosthetic replacement had to be performed. In case of a shoulder dislocation with a complex fracture after an epileptic seizure, prosthetic replacement is the choice of treatment.
伴有骨折的肩关节脱位是癫痫发作可能出现的并发症，且常常在初诊时被漏诊。发生缺血性肱骨头坏死（AVN）的几率很高，主要治疗方式是假体置换。在本文中，我们描述了这样一个罕见病例：一名48岁男性患者在首次癫痫发作后，双侧同时发生后肩关节脱位并伴有双侧肱骨头骨折。左侧采用角稳定钢板接骨术进行切开复位内固定。在同一手术中，右侧植入了半关节假体。术后一年半，右侧功能不佳，左侧出现AVN，不得不进行二期假体置换。对于癫痫发作后伴有复杂骨折的肩关节脱位，假体置换是治疗的选择。
