Du Weibin, Mo Yafeng, Dong Yi, He Chun, Zhou Fengzhen, Zhu Fangbing
Research Institute of Orthopedics, The Affiliated Jiangnan Hospital of Zhejiang Chinese Medical University, Hangzhou 312001, Zhejiang, China.
Department of Orthopaedics, Hangzhou Xiaoshan Hospital of Traditional Chinese Medicine, Hangzhou 312001, Zhejiang, China.
J Surg Case Rep. 2023 Sep 8;2023(9):rjad499. doi: 10.1093/jscr/rjad499. eCollection 2023 Sep.
Traumatic anterior dislocation of the shoulder is often associated with anterior glenoid fracture or bankart injury. It can also be associated with rotator cuff injury, humeral greater tuberosity fracture, or brachial plexus injury. However, there are few clinical reports of all the above-mentioned injuries at the same time. We report a case of the left "Shoulder terrible tetrad." After closed reduction of the left shoulder dislocation, we performed one-stage arthroscopic massive rotator cuff repair (Chinese-Way technique) and anchor repair of the bony bankart injury. After 2 years follow-up, the left shoulder function recovered well and the range of motion was satisfactory. A detailed physical examination and electromyography (EMG) examination should be performed in time to avoid misdiagnosis and missed diagnosis, when the clinical manifestation of brachial plexus nerve injury appears after shoulder dislocation. The repairable rotator cuffs tears and bankart injuries can be repaired under shoulder arthroscopy in one stage.
创伤性肩关节前脱位常伴有前盂肱关节骨折或Bankart损伤。它也可能与肩袖损伤、肱骨大结节骨折或臂丛神经损伤相关。然而，同时出现上述所有损伤的临床报道很少。我们报告一例左侧“肩关节恐怖四联症”病例。在左侧肩关节脱位闭合复位后，我们一期进行了关节镜下肩袖大规模修复（中国术式）及骨性Bankart损伤的锚钉修复。经过2年随访，左侧肩关节功能恢复良好，活动范围满意。当肩关节脱位后出现臂丛神经损伤的临床表现时，应及时进行详细的体格检查和肌电图（EMG）检查，以避免误诊和漏诊。可修复的肩袖撕裂和Bankart损伤可在肩关节镜下一期修复。
