Bekmezci Taner, Altan Egemen
Department of Orthopaedics and Traumatology, Liv Hospital, Bahcesehir University, Istanbul, Turkey.
Orthopaedics and Traumatology, Selcuk University, Konya, Turkey.
Arch Trauma Res. 2015 Dec 1;4(4):e29903. doi: 10.5812/atr.29903. eCollection 2015 Dec.
Posterior fracture-dislocations of the shoulder are rare conditions. Misdiagnosis can occur in 50% - 80% of the patients. Due to the size of the lesion, stability of the joint could not be achieved with transfer of subscapular tendon or tuberosity.
A 54-year-old male patient was referred to our hospital with a neglected posterior shoulder fracture-dislocation. Functional results of the patient, and technical informations were explained in this case report. The reverse Hill-Sachs lesion involved 40% of the articular surface. Depressed and malunited fragment was elevated, and fixated to the humeral head.
Glenohumeral joint reduction with reconstruction of the humeral head seems to be possible even in a neglected locked posterior shoulder fracture-dislocation. If the depressed osteochondral fragment is still spheric, signs of the avascular necrosis are absent on CT, and malunion of the fragment has occurred, it is quite possible to reconstruct the head. Although results of the case are good, it is worthwhile to follow these patients for long-term complications.
肩关节后脱位骨折较为罕见。50% - 80%的患者可能会出现误诊。由于损伤面积较大，通过肩胛下肌腱或结节转移无法实现关节的稳定性。
一名54岁男性患者因被忽视的肩关节后脱位骨折转诊至我院。本病例报告阐述了该患者的功能结果及技术信息。反Hill-Sachs损伤累及40%的关节面。将凹陷且愈合不良的骨折块抬起并固定于肱骨头。
即使是被忽视的锁定性肩关节后脱位骨折，通过肱骨头重建实现盂肱关节复位似乎也是可行的。如果凹陷的骨软骨骨折块仍呈球形，CT上无缺血性坏死迹象，且骨折块已发生畸形愈合，那么重建肱骨头是很有可能的。尽管该病例结果良好，但仍值得对这些患者进行长期随访以观察并发症。
