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急性巨大肩袖撕裂伴肩关节后脱位:一种罕见损伤的关节镜下新型修复。病例报告。

Acute massive rotator cuff rupture with posterior shoulder dislocation: arthroscopic novel repair of a rare injury. A case report.

机构信息

Orthopaedic Surgery, Fundación Clínica del Norte, Medellín, Colombia.

Orthopedic Surgery, University of Antioquia Faculty of Medicine, Medellín, Colombia

出版信息

J ISAKOS. 2021 Nov;6(6):375-379. doi: 10.1136/jisakos-2020-000553. Epub 2021 Jun 16.

Abstract

Acute massive rotator cuff tears and posterior shoulder dislocations are an extremely rare association, and a vast majority are treated by open surgery. We present a case of a man in his 20s who suffered closed left shoulder trauma after a road traffic accident. He was initially diagnosed with posterior shoulder dislocation and a reduction was successfully performed. However, the patient still complained of persistent weakness during active movements. We found a massive rotator cuff tear involving all the rotator cuff tendons, with significant supraspinatus retraction and persistent posterior shoulder subluxation. He underwent an all-arthroscopic repair of the rotator cuff with a double-row technique in the subscapularis, supraspinatus and infraspinatus muscles. Capsular repair and tenodesis of the biceps tendon were also performed. The patient had good recovery, reaching full preinjury function 3 months after surgery with a successful return to his regular activities.

摘要

急性巨大肩袖撕裂和后向肩关节脱位极为罕见,绝大多数需要开放手术治疗。我们报告一例 20 多岁男性,因道路交通事故致左侧肩部闭合性创伤。患者最初被诊断为后向肩关节脱位,复位后成功。然而,患者仍抱怨主动活动时持续无力。我们发现巨大肩袖撕裂累及所有肩袖肌腱,冈上肌明显回缩,持续后向肩关节半脱位。患者接受了全关节镜下肩袖修复术,采用双排技术修复肩胛下肌、冈上肌和冈下肌。同时进行了关节囊修复和肱二头肌肌腱固定术。术后 3 个月,患者恢复良好,恢复到术前的全部功能,成功回归正常活动。

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