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一期手术治疗陈旧性双侧同时性肩关节后脱位:1例报告及文献复习

One-stage surgical treatment of neglected simultaneous bilateral locked posterior dislocation of shoulder: a case report and literature review.

作者信息

Elmalı Nurzat, Taşdemir Zeki, Sağlam Fevzi, Gülabi Deniz, Baysal Özgür

机构信息

Department of Orthopedics and Traumatology, Bezmialem Vakıf University, 34093 Fatih, İstanbul, Turkey.

出版信息

Eklem Hastalik Cerrahisi. 2015;26(3):175-80. doi: 10.5606/ehc.2015.36.

Abstract

Simultaneous bilateral locked posterior dislocation of the shoulder is a rare injury. Herein, we present a 59-year-old male case with a three-month history of an irreducible locked bilateral posterior dislocation of the shoulders with an associated large impression fracture on the anteromedial aspect of both humeral heads after a grand mal type epileptic seizure. Plain X-ray and computed tomograph revealed a defect on the right side more than 40% of the articular surface, and on the left side, 30%. He was treated with a one-stage operation with a reconstruction of femoral head osteochondral allograft on the right side and transfer of the osteotomized tuberculum minus with its attached subscapularis tendon into the defect (modified McLaughlin technique) on the left side. At 14 months during follow-up, the patient was pain-free with stable shoulder joints and satisfactory functionality.

摘要

双侧肩关节同时发生锁定性后脱位是一种罕见的损伤。在此,我们报告一例59岁男性病例,该患者在癫痫大发作后出现双侧肩关节不可复位的锁定性后脱位,伴有双侧肱骨头内侧前部较大的凹陷骨折,病程3个月。X线平片和计算机断层扫描显示右侧关节面缺损超过40%,左侧为30%。患者接受了一期手术治疗,右侧采用股骨头异体骨软骨移植重建,左侧采用将截下的小结节及其附着的肩胛下肌腱转移至缺损处(改良麦克劳林技术)。随访14个月时,患者肩关节无痛,关节稳定,功能良好。

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