Morán Nicolás, Marsalli Michael, Vargas Mauricio, De la Paz Joaquín, Cartaya Marco
Shoulder and Elbow Unit, Orthopedic Department, Hospital Militar de Santiago, Santiago, Chile.
Orthopedic Department, Clínica RedSalud Santiago, Santiago, Chile.
Clin Shoulder Elb. 2022 Dec;25(4):288-295. doi: 10.5397/cise.2022.00892. Epub 2022 Aug 16.
There is no standardized therapeutic strategy for locked posterior shoulder fracture-dislocation (PSFD), and no consensus exists on the analysis of preoperative factors. This retrospective study aimed to evaluate functional results and complications in a series of PSFD cases managed with open surgical treatment.
Patients diagnosed with locked PSFD who underwent open surgical treatment with reduction and osteosynthesis between April 2016 and March 2020 were included. All participants were treated with open reduction and internal fixation. Functional assessment used the modified University of California, Los Angeles (UCLA) mod scale, American Shoulder and Elbow Surgeons (ASES) questionnaire, subjective shoulder value (SSV), and visual analog scale (VAS). Complications were evaluated clinically and radiologically by X-ray and computed tomography.
Twelve shoulders were included (11 patients; mean age, 40.6 years; range, 19- 62 years). The mean follow-up duration was 23.3 months (range, 12-63 months). The UCLA mod, ASES, SSV, and VAS scores were 29.1±3.7, 81.6±13.5, 78±14.8, and 1.2±1.4 points, respectively. The overall complication rate was 16.6%, with one case of post-traumatic stiffness, 1 case of chronic pain, and no cases of avascular necrosis.
Open surgical treatment of locked PSFD can achieve good functional results. A correct understanding of these injuries and good preoperative planning helped us to achieve a low rate of complications.
对于锁定性肩后脱位（PSFD），目前尚无标准化的治疗策略，术前因素分析也未达成共识。本回顾性研究旨在评估一系列采用开放手术治疗的PSFD病例的功能结果及并发症情况。
纳入2016年4月至2020年3月期间诊断为锁定性PSFD并接受切开复位内固定手术治疗的患者。所有参与者均接受切开复位内固定治疗。功能评估采用改良的加州大学洛杉矶分校（UCLA）评分量表、美国肩肘外科医师学会（ASES）问卷、主观肩关节评价值（SSV）和视觉模拟量表（VAS）。通过X线和计算机断层扫描对并发症进行临床和影像学评估。
共纳入12例肩部病例（11例患者；平均年龄40.6岁；范围19 - 62岁）。平均随访时间为23.3个月（范围12 - 63个月）。UCLA评分量表、ASES、SSV和VAS评分分别为29.1±3.7分、81.6±13.5分、78±14.8分和1.2±1.4分。总体并发症发生率为16.6%，其中创伤后僵硬1例，慢性疼痛1例，无缺血性坏死病例。
锁定性PSFD的开放手术治疗可取得良好的功能结果。对这些损伤的正确认识和良好的术前规划有助于我们降低并发症发生率。
