Leslie B M, Harris J M, Driscoll D
Department of Orthopaedic Surgery, New England Medical Center, Boston, Massachusetts 02111.
J Bone Joint Surg Am. 1989 Dec;71(10):1516-22.
Septic arthritis of the shoulder is uncommon in adults. We reviewed the cases of eighteen patients who were followed for a minimum of one year. The patients ranged in age from forty-two to eighty-nine years. All but one patient had at least one serious associated disease. Eight patients had had an injection or aspiration of the shoulder before development of the infection. All but one patient had had a delay in diagnosis. At the time of admission to the hospital, the erythrocyte sedimentation rate was always elevated, but the body temperature and white blood-cell count were not. After treatment, the functional result was usually poor: only five patients regained forward flexion to 90 degrees or more, eight patients had no active motion of the glenohumeral joint, and two patients died. Arthrotomy appeared to afford a better result than did repeated aspiration.
成人肩关节化脓性关节炎并不常见。我们回顾了18例患者的病例，这些患者至少随访了一年。患者年龄在42岁至89岁之间。除1例患者外，所有患者都至少有一种严重的相关疾病。8例患者在感染发生前曾接受过肩部注射或穿刺。除1例患者外，所有患者都存在诊断延误。入院时，红细胞沉降率总是升高，但体温和白细胞计数正常。治疗后，功能结果通常较差：只有5例患者前屈恢复到90度或以上，8例患者肩肱关节无主动活动，2例患者死亡。关节切开术似乎比反复穿刺效果更好。
