Prasetia Renaldi, Handoko Hans Kristian, Rosa Wendy Yolanda, Ismiarto Adrian Fakhri, Utoyo Ghuna Arioharjo
Department of Orthopaedics and Traumatology, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia.
General Practitioner, Faculty of Medicine, Maranatha Christian University, Bandung, West Java, Indonesia.
Int J Surg Case Rep. 2022 Jun;95:107200. doi: 10.1016/j.ijscr.2022.107200. Epub 2022 May 16.
The shoulder is one of the most unstable joints of the body. Shoulder dislocation accounts for up to 60% of all major joint dislocations. This study reports two cases of primary traumatic shoulder dislocation and shows that in the elderly, primary traumatic shoulder dislocation is associated with a rotator cuff tear (RCT).
A case report and narrative review included two female patients, aged 63 and 100 years. Presenting symptoms were instability, pain, and restricted shoulder movement. Both were successfully treated by surgery. Arthroscopy was performed in the first patient and open reduction in the second patient.
In the first case, we found synovitis around the rotator interval, long head of the biceps tendinitis, and tears of the subscapularis tendon, supraspinatus tendon, and subacromial bursitis. The anterior labrum was normal. In the second case, complete detachment of the infraspinatus tendon was found. In both cases, rotator cuff repair was performed. Primary traumatic shoulder dislocation in the elderly is often associated with rotator cuff injury. Therefore, a detailed evaluation and management of the rotator cuff injury is essential. Rotator cuff injuries cause loss of dynamic stabilization of the shoulder, leading to recurrent shoulder dislocation and chronic shoulder instability.
The associated pathology of the primary traumatic shoulder dislocation in elderly are rotator cuff tear. The management of the rotator cuff tear in primary traumatic shoulder dislocation can prevent further shoulder instability events.
肩部是人体最不稳定的关节之一。肩关节脱位占所有主要关节脱位的比例高达60%。本研究报告了两例原发性创伤性肩关节脱位病例，并表明在老年人中，原发性创伤性肩关节脱位与肩袖撕裂（RCT）相关。
一份病例报告及叙述性综述纳入了两名女性患者，年龄分别为63岁和100岁。主要症状为肩部不稳定、疼痛和活动受限。两人均通过手术成功治疗。第一例患者接受了关节镜检查，第二例患者接受了切开复位。
在第一例病例中，我们发现了旋转间隙周围的滑膜炎、肱二头肌长头肌腱炎以及肩胛下肌腱、冈上肌腱撕裂和肩峰下滑囊炎。前盂唇正常。在第二例病例中，发现冈下肌腱完全撕裂。两例均进行了肩袖修复。老年人原发性创伤性肩关节脱位常与肩袖损伤相关。因此，对肩袖损伤进行详细评估和处理至关重要。肩袖损伤会导致肩部动态稳定功能丧失，从而导致复发性肩关节脱位和慢性肩部不稳定。
老年人原发性创伤性肩关节脱位的相关病理改变为肩袖撕裂。原发性创伤性肩关节脱位中肩袖撕裂的处理可预防进一步的肩部不稳定事件。
