Pritchett J W, Clark J M
Clin Orthop Relat Res. 1987 Mar(216):89-93.
Seven patients with chronic dislocations of the shoulder were treated by humeral head or total shoulder replacement. All patients had significant humeral head damage. Three dislocations were posterior and four were anterior. All had been unreduced for at least two months. A Neer prosthesis was used in each patient and the version of the humeral component was altered by 30 degrees-50 degrees away from the direction of the dislocation. Only a sling and swathe was used postoperatively, and the patient was allowed early motion in a limited-goals physical therapy program. There were no redislocations and all patients were improved over their preoperative status. Five patients achieved a good result and two had a fair result based on a 100-unit rating system. One transient axillary nerve palsy occurred, but there were no other complications. Prosthetic replacement for chronic unreduced shoulder dislocations is a reliable procedure when severe humeral head damage exists.
7例慢性肩关节脱位患者接受了肱骨头置换或全肩关节置换治疗。所有患者均有明显的肱骨头损伤。3例为后脱位，4例为前脱位。所有脱位均未复位至少2个月。每位患者均使用Neer假体，肱骨组件的方向相对于脱位方向改变30度至50度。术后仅使用吊带和绷带，患者在有限目标的物理治疗方案中可早期活动。无再脱位发生，所有患者的术后状况均较术前有所改善。基于100分的评分系统，5例患者效果良好，2例效果尚可。发生1例短暂性腋神经麻痹，但无其他并发症。当存在严重肱骨头损伤时，假体置换治疗慢性未复位肩关节脱位是一种可靠的手术方法。
