Kurowicki Jennifer, Triplet Jacob J, Berglund Derek D, Zink Thomas, Rosas Samuel, Levy Jonathan C
Department of Orthopaedics, School of Health and Medical Sciences, Seton Hall University, South Orange, New Jersey.
OhioHealth Doctors Hospital, Columbus, Ohio.
JBJS Case Connect. 2018 Apr-Jun;8(2):e36. doi: 10.2106/JBJS.CC.17.00204.
An 80-year-old woman sustained a fracture-dislocation of the proximal aspect of the humerus with a near-complete brachial plexopathy, which was successfully managed acutely using a reverse shoulder arthroplasty (RSA) with repair of the greater and lesser tuberosities. The palsy, which was confirmed with nerve conduction studies, recovered uneventfully along with functional improvement of the shoulder. At the most recent follow-up, there was complete resolution of the plexopathy, with excellent, pain-free range of motion.
Acute RSA with tuberosity repair may be a reasonable treatment modality in the setting of an acute brachial plexus palsy following a comminuted fracture-dislocation of the proximal aspect of the humerus in an elderly patient.
一名80岁女性发生肱骨近端骨折脱位并伴有近乎完全性臂丛神经病变,通过采用反向全肩关节置换术(RSA)并修复大、小结节,成功进行了急性期处理。经神经传导研究证实的神经麻痹随着肩部功能改善而顺利恢复。在最近一次随访时,神经病变完全消退,肩关节活动范围良好且无痛。
对于老年患者肱骨近端粉碎性骨折脱位后发生急性臂丛神经麻痹的情况,急性期行RSA并修复结节可能是一种合理的治疗方式。