Ben Fadhel Wael, Ghrairi Roman, Sabathe Sylvain, Bégué Thierry
Department of Orthopedic, Trauma and Reconstructive Surgery, Antoine Béclère Hospital, AP-HP, Paris-Saclay University, France.
Trauma Case Rep. 2022 Aug 8;41:100691. doi: 10.1016/j.tcr.2022.100691. eCollection 2022 Oct.
We present the case of a 71-year-old man who suffered a bilateral posterior fracture-dislocation of the shoulder after an idiopathic seizure. After immediate closed reduction, CT-scan images revealed bilateral anterior reverse Hill-Sachs lesion superior to 30 % of the articular humeral head. A surgical treatment was performed for reconstruction of segmental defects of the articular humeral heads followed by filling the defect using lesser tuberosity transposition. Early rehabilitation protocol was prescribed. After 14 months, the patient returned to normal daily activities with no complaint. Anatomical humeral head reconstruction and bone defect filling resulted in a good clinical outcome after posterior shoulder dislocation. It can be the treatment of choice for large humeral head defects, especially in younger patients with good bone stock.
我们报告一例71岁男性患者，其在特发性癫痫发作后出现双侧肩关节后脱位骨折。立即进行闭合复位后，CT扫描图像显示双侧肱骨头前部反Hill-Sachs损伤超过肱骨头关节面的30%。对肱骨头节段性缺损进行了手术重建，随后采用小粗隆转位填充缺损。制定了早期康复方案。14个月后，患者恢复正常日常活动，无不适主诉。肱骨头解剖重建和骨缺损填充在肩关节后脱位后取得了良好的临床效果。对于大的肱骨头缺损，尤其是骨质良好的年轻患者，这可能是首选的治疗方法。
