Department of Orthopaedic Surgery and Trauma, Flinders Medical Centre, Adelaide, SA, Australia.
College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia.
Arch Orthop Trauma Surg. 2020 Apr;140(4):443-447. doi: 10.1007/s00402-019-03242-3. Epub 2019 Aug 5.
An intrathoracic shoulder dislocation is a rare injury, usually the result of high-energy trauma [Hawkes et al. in Am J Orthop 43(4):E74-E78, 2014; Tsai et al. in Ann Thorac Cardiovasc Surg 20:592-594, 2014, in Rupprecht et al. Bull Emerg Trauma 5(3):212-214, 2017; Abellan et al. J Orthop Surg (Hong Kong)18(2):254-257, 2010]. It often occurs in conjunction with thoracic, pelvic, and long bone injuries. In addition, there is often significant injuries to the shoulder girdle and chest wall associated with neurovascular compromise [Abellan et al. J Orthop Surg (Hong Kong)18(2):254-257, 2010; Lin et al. JBJS Case Connect 6(1):e61, 2016]. Following a literature review, it appears that no cases have been reported of an intrathoracic shoulder dislocation associated with a rupture of the ipsilateral main bronchus. We present a case of a rupture of the right main bronchus that occurred due to high-energy impact and an associated intrathoracic right-shoulder fracture dislocation. Computed tomography identified diastasis of the ipsilateral first intercostal space, humeral head indentation in the hilum of the lung, and a pneumoarthrogram of the right glenohumeral joint.
胸腔内肩关节脱位是一种罕见的损伤,通常是高能创伤的结果 [Hawkes 等人,《美国矫形外科杂志》43(4):E74-E78,2014;Tsai 等人,《胸心血管外科年鉴》20:592-594,2014,在 Rupprecht 等人的《紧急创伤通报》5(3):212-214,2017;Abellan 等人,《矫形外科杂志(香港)》18(2):254-257,2010]。它常与胸、骨盆和长骨损伤同时发生。此外,常伴有严重的肩部和胸壁损伤,以及神经血管受压 [Abellan 等人,《矫形外科杂志(香港)》18(2):254-257,2010;Lin 等人,《JBJS 病例连接》6(1):e61,2016]。经过文献回顾,似乎没有报道过胸腔内肩关节脱位合并同侧主支气管破裂的病例。我们报告了一例因高能撞击导致右侧主支气管破裂和同侧胸腔内右肩关节骨折脱位的病例。计算机断层扫描显示同侧第一肋间隙分离,肺门处肱骨头凹陷,以及右侧盂肱关节气-液平。