van Gerven Pieter, Buijs Nikki, Blaas Leanne, Yuan J Zhang, de Priester Jacobus A, Derksen Robert Jan
Department of Surgery, Zaandam Medical Center, Koningin Julianaplein 58, 1502 DV Zaandam, The Netherlands.
Department of Radiology, Zaandam Medical Center, Koningin Julianaplein 58, 1502 DV Zaandam, The Netherlands.
J Clin Med. 2024 Aug 17;13(16):4862. doi: 10.3390/jcm13164862.
Neglected anterior glenohumeral dislocations provide a challenging problem for physicians. For many patients with these injuries, reverse shoulder arthroplasty has been the treatment of choice, although the preservation of the patient's own humeral head might have significant advantages. We present a case of a 66-year-old male with a neglected anterior glenohumeral dislocation that he sustained 6 weeks prior when he was hit by a car as a pedestrian. Radiographic imaging revealed a large off-track Hill-Sachs deformity and a fracture of the greater tuberosity in addition to the persisting glenohumeral dislocation. We performed open reduction and to aid stability, an infraspinatus tendon remplissage and a Latarjet procedure were performed. Apart from minor and self-limiting neuropraxia, recovery was without complications. At 24 month follow-up, the patient had no impairment in general activities, had no residual pain, and had a good active range of motion. The authors, therefore, believe that a combination of infraspinatus tendon remplissage and the Latarjet procedure seems a feasible alternative for reverse shoulder arthroplasty and can preserve the patient's own humeral head.
被忽视的前肩关节脱位给医生带来了一个具有挑战性的问题。对于许多患有这些损伤的患者，反肩关节置换术一直是首选的治疗方法，尽管保留患者自身的肱骨头可能具有显著优势。我们报告一例66岁男性患者，他在6周前作为行人被汽车撞击时发生了被忽视的前肩关节脱位。影像学检查显示，除了持续存在的肩关节脱位外，还有一个较大的脱轨型希尔-萨克斯畸形和大结节骨折。我们进行了切开复位，并为了增强稳定性，实施了冈下肌腱填充术和拉塔热手术。除了轻微的、自限性的神经失用症外，恢复过程没有并发症。在24个月的随访中，患者的日常活动没有受损，没有残留疼痛，并且有良好的主动活动范围。因此，作者认为冈下肌腱填充术和拉塔热手术相结合似乎是反肩关节置换术的一种可行替代方案，并且可以保留患者自身的肱骨头。
