Saadat Waqar, Monga Puneet
Department TVauma and Orthopaedic, Furness General Hospital, Barrow-in-Furness, England, UK.
Department Trauma and Orthopaedic, Wrightington, Wigan and Leigh NHS Trust, England, UK.
J Orthop Case Rep. 2017 Nov-Dec;7(6):24-26. doi: 10.13107/jocr.2250-0685.934.
Posteriorly dislocated humeral head fracture has a great implication, as it is associated with high risk of avascular necrosis, limited access through the deltopectoral approach, and posterior approach to the posteriorly dislocated humeral fracture increases the risk to the remaining blood supply.
Posteriorly dislocated humeral fracture is approached through deltopectoral approach. Schanz pin is inserted into the humeral head to achieve purchase in the humeral head. Applying laterally directed force the humeral head is disengaged from the lateral margin of glenoid. A rotatory force then repositions the humeral head into a congruous position. Open reduction internal fixation is then carried out in a standard fashion.
Retrieving the humeral head from the posteriorly dislocated position in patients with posterior fracture dislocation of the shoulder can be challenge to a trauma surgeon. With this novel technique, humeral head is reduced through deltopectoral approach without increasing the risk to the remaining blood supply.
肱骨头后脱位骨折具有重大影响，因为它与缺血性坏死的高风险、经三角肌胸大肌入路的有限暴露以及采用后入路治疗肱骨头后脱位骨折会增加剩余血供受损的风险相关。
通过三角肌胸大肌入路处理肱骨头后脱位骨折。将斯氏针插入肱骨头以获得对肱骨头的把持。施加侧向力使肱骨头从关节盂外侧边缘脱离。然后通过旋转力将肱骨头复位至合适位置。接着以标准方式进行切开复位内固定。
对于肩部后骨折脱位患者，将肱骨头从后脱位位置复位对创伤外科医生而言可能是一项挑战。采用这种新技术，可通过三角肌胸大肌入路复位肱骨头，而不会增加剩余血供受损的风险。
