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老年急性肩关节前脱位合并孤立性大盂肱关节骨折：反式肩关节置换术的新适应症

Isolated Large Glenoid Fracture in Acute Glenohumeral Dislocation in the Elderly: A Novel Indication for Reverse Shoulder Arthroplasty.

作者信息

Smith Tyler, D'Alonzo Joseph, Arevalo Alfonso, Kazanjian Jack

机构信息

Department of Orthopedic Surgery, Philadelphia College of Osteopathic Medicine, 4190 City Ave, Philadelphia, PA, USA.

出版信息

Case Rep Orthop. 2020 Aug 12;2020:8826803. doi: 10.1155/2020/8826803. eCollection 2020.

DOI:10.1155/2020/8826803
PMID:32855832
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7443034/
Abstract

CASE

Two elderly males presented with traumatic shoulder dislocation and bony Bankart fracture consisting of greater than 25% of the glenoid width. Due to several concomitant factors such as polytrauma, activity level, rotator cuff pathology, optimization of comorbidities, risk of complications, and potential for revision surgery, the patients were treated with reverse shoulder arthroplasty (RSA).

CONCLUSION

RSA may be a satisfactory treatment option for isolated, large glenoid fractures associated with anterior glenohumeral instability in the elderly. These patients are susceptible to rapid deconditioning with prolonged immobilization and may not be medically suited to undergo the prolonged recovery period associated with open reduction internal fixation or potentially undergo revision operations.

摘要

病例

两名老年男性患者因创伤性肩关节脱位及骨性Bankart骨折就诊，骨折累及范围超过肩胛盂宽度的25%。由于存在多处创伤、活动水平、肩袖病变、合并症的优化、并发症风险以及翻修手术可能性等多种伴随因素，这两名患者接受了反式肩关节置换术（RSA）治疗。

结论

对于老年患者中与前盂肱关节不稳相关的孤立性、大型肩胛盂骨折，RSA可能是一种令人满意的治疗选择。这些患者因长期固定易出现快速身体机能衰退，且在医学上可能不适合经历与切开复位内固定相关的较长恢复期，或可能无法接受翻修手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3482/7443034/53135e5264d7/CRIOR2020-8826803.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3482/7443034/cf0912cf46e9/CRIOR2020-8826803.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3482/7443034/9136359f5133/CRIOR2020-8826803.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3482/7443034/54175486b9b5/CRIOR2020-8826803.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3482/7443034/fc0ac090210e/CRIOR2020-8826803.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3482/7443034/53135e5264d7/CRIOR2020-8826803.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3482/7443034/cf0912cf46e9/CRIOR2020-8826803.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3482/7443034/9136359f5133/CRIOR2020-8826803.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3482/7443034/54175486b9b5/CRIOR2020-8826803.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3482/7443034/fc0ac090210e/CRIOR2020-8826803.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3482/7443034/53135e5264d7/CRIOR2020-8826803.005.jpg

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JBJS Case Connect. 2019 Jan-Mar;9(1):e13. doi: 10.2106/JBJS.CC.18.00237.
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Reverse shoulder arthroplasty with glenoid bone grafting for anterior glenoid rim fracture associated with glenohumeral dislocation and proximal humerus fracture.采用关节盂植骨的反式肩关节置换术治疗与盂肱关节脱位和肱骨近端骨折相关的关节盂前缘骨折。
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Reverse shoulder arthroplasty for the management of proximal humerus fractures.
Treatment of coronal split glenoid fracture utilizing open reduction internal fixation with immediate intraoperative conversion to rTSA: a novel approach.
采用切开复位内固定并在术中立即转换为反式全肩关节置换术治疗冠状面劈裂的肩胛盂骨折：一种新方法。
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