Abdulahi Mohamoud, Ali Abdirahman Omer, Said Abdirahman Ibrahim, Walhad Hodan, Elmi Hassan Sh Abdirahman
College of Health Sciences, School of Medicine and Surgery, Amoud University, Borama 25263, Somalia; Surgical Department, Borama Regional Hospital, Borama 25263, Somalia.
College of Health Sciences, School of Medicine and Surgery, Amoud University, Borama 25263, Somalia; School of Postgraduate Studies and Research, Amoud University, Amoud Valley, Borama 25263, Somalia.
Int J Surg Case Rep. 2024 Nov;124:110402. doi: 10.1016/j.ijscr.2024.110402. Epub 2024 Oct 2.
Shoulder dislocation is very common. However, neglected or chronic shoulder dislocations are extremely rare. The position of the humeral head determines the classification of shoulder dislocation. Anterior shoulder dislocation accounts for most cases, while inferior dislocation is rare. Negligence from the patient and misdiagnosis are the leading causes of chronic shoulder dislocation. Treatment of the condition poses a significant challenge for surgeons since there is no widely accepted treatment protocol.
A 56-year-old woman presented with a neglected anterior subglenoid dislocation of the shoulder joint. The dislocation occurred due to a cow kick, and initial treatment from a traditional healer and an unqualified health practitioner failed. Clinical examination and X-ray confirmed the dislocation without associated fractures. An initial attempt at closed reduction under sedation was unsuccessful. Subsequently, open reduction and a Latarjet procedure were performed successfully, resulting in a satisfactory outcome.
Chronic anterior dislocation primarily affects the elderly population. Open reduction and fixation procedures have shown satisfactory outcomes. The choice of treatment depends on several factors, including bone deficiencies, soft tissue damage, and the presence of Hill-Sachs or Bankart lesions. Open reduction and laterjet procedure is a validated treatment. However, early physical therapy contributes to favorable outcomes.
The condition's rarity makes it difficult to establish a well-accepted treatment protocol. Early and strict rehabilitation protocols will lead to a favorable outcome.
肩关节脱位非常常见。然而，被忽视的或慢性肩关节脱位极为罕见。肱骨头的位置决定了肩关节脱位的分类。肩关节前脱位占大多数病例，而下脱位则很少见。患者的疏忽和误诊是慢性肩关节脱位的主要原因。由于没有广泛接受的治疗方案，这种疾病的治疗对外科医生构成了重大挑战。
一名56岁女性因被忽视的肩关节前下盂脱位前来就诊。脱位是由牛踢所致，最初由传统治疗师和不合格的医疗从业者进行的治疗失败。临床检查和X线检查证实脱位且无相关骨折。最初在镇静下尝试闭合复位未成功。随后，成功进行了切开复位和Latarjet手术，结果令人满意。
慢性前脱位主要影响老年人群。切开复位和固定手术已显示出令人满意的结果。治疗方法的选择取决于几个因素，包括骨缺损、软组织损伤以及是否存在希尔-萨克斯损伤或肩胛盂唇损伤。切开复位和Latarjet手术是一种经过验证的治疗方法。然而，早期物理治疗有助于取得良好的效果。
该疾病的罕见性使得难以建立广泛接受的治疗方案。早期和严格的康复方案将带来良好的结果。
