Shah Kunal, Ubale Tushar, Ugrappa Harish, Pilankar Samir, Bhaskar Atul, Kale Satishchandra
Department of Orthopaedics, R.n.cooper Municipal General Hospital, Bhaktivedanta Swami Marg, Juhu, Mumbai 400056.
J Orthop Case Rep. 2015 Oct-Dec;5(4):61-3. doi: 10.13107/jocr.2250-0685.348.
Shoulder joint is the most frequently dislocated joint. However, it is rarely neglected and treatment is sought immediately. Delayed or neglected shoulder dislocations are difficult to manage and require extensive procedures to obtain good functional outcome. Very few cases are described in literature showing neglected shoulder dislocation with good functional range of movement. We report a case with 3 years of neglected anterior shoulder dislocation with preserved joint function.
A 40 years old gentleman presented withfracture distal end of the radius (left). On clinical examination we observed that he had anterior dislocation of his left shoulder which was confirmed on radiographic evaluation. He had history of seizures 3 years back, which may be the cause of dislocation which went unnoticed. On examination he had good range of motion without any pain. Patient could perform all routine activities with no major functional limitation. At three years after dislocation CT Scan showed neocavity formation.
Neglected shoulder dislocation with preserved joint function without major functional limitation is a rare presentation. This condition should be kept in mind in patients with history of seizures. Proper evaluation and counseling of patients avoids extensive procedures and avoids complications of surgery. Observation can be a treatment option in patients with preserved range of movement especially involving non dominant handand having low functional demand. This report presents rare presentation of neglected shoulder dislocation highlighting its natural history and its outcome following conservative treatment.
肩关节是最常发生脱位的关节。然而，它很少被忽视，患者通常会立即寻求治疗。延迟或被忽视的肩关节脱位难以处理，需要进行广泛的手术才能获得良好的功能结果。文献中描述的显示被忽视的肩关节脱位且运动功能范围良好的病例非常少。我们报告一例被忽视的前肩关节脱位3年但关节功能保留的病例。
一名40岁男性因左侧桡骨远端骨折前来就诊。临床检查时，我们发现他左侧肩关节前脱位，影像学评估证实了这一情况。他3年前有癫痫病史，这可能是脱位未被注意到的原因。检查发现他的活动范围良好，没有疼痛。患者能够进行所有日常活动，没有明显的功能限制。脱位三年后的CT扫描显示有新腔形成。
被忽视的肩关节脱位且关节功能保留、无明显功能限制是一种罕见的情况。有癫痫病史的患者应考虑到这种情况。对患者进行适当的评估和咨询可避免进行广泛的手术并避免手术并发症。对于活动范围保留的患者，尤其是涉及非优势手且功能需求较低的患者，观察可以作为一种治疗选择。本报告展示了被忽视的肩关节脱位的罕见情况，突出了其自然病程以及保守治疗后的结果。
