Baek Samuel, Lee Geum-Ho, Shin Myung Ho, Kim Tae Min, Oh Kyung-Soo, Chung Seok Won
Department of Orthopaedic Surgery, Seoul Red Cross Hospital, Seoul, Korea.
Department of Orthopaedic Surgery, CM Hospital, Seoul, Korea.
Clin Shoulder Elb. 2023 Sep;26(3):302-305. doi: 10.5397/cise.2022.00794. Epub 2022 May 11.
The authors present a case of transient postoperative inferior subluxation of the shoulder after arthroscopic surgical stabilization for recurrent anterior dislocation. The patient was a 61-year-old woman with myasthenia gravis (MG). The first anterior shoulder dislocation occurred because of a fall to the ground. Despite a successful closed reduction, two more dislocations occurred in 3 weeks. Magnetic resonance imaging revealed an anterior labroligamentous periosteal sleeve avulsion (ALPSA) lesion, an engaging Hill-Sachs lesion, and large tears of the supraspinatus and infraspinatus tendons. The patient underwent arthroscopic rotator cuff repair and ALPSA repair with a remplissage procedure. Intraoperatively, no tendency for instability was found; however, a widened glenohumeral joint space and inferior subluxation of the humeral head without functional compromise was observed on the day after surgery and disappeared spontaneously on radiographs 2 weeks later. To the authors' knowledge, this is the first report documenting the occurrence of transient postoperative inferior subluxation of the shoulder in a patient with MG.
作者报告了1例复发性前脱位经关节镜手术稳定治疗后出现短暂性术后肩关节下脱位的病例。患者为一名61岁患重症肌无力(MG)的女性。首次肩关节前脱位是因摔倒在地所致。尽管闭合复位成功,但在3周内又发生了2次脱位。磁共振成像显示存在前盂唇韧带骨膜袖套撕脱(ALPSA)损伤、嵌顿性希尔-萨克斯损伤以及冈上肌和冈下肌肌腱的巨大撕裂。患者接受了关节镜下肩袖修复和采用充填术的ALPSA修复。术中未发现不稳定倾向;然而,术后第1天观察到盂肱关节间隙增宽和肱骨头下脱位,但未出现功能受损情况,2周后X线片显示脱位已自行消失。据作者所知,这是首篇记录MG患者术后出现短暂性肩关节下脱位的报告。