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双侧肩关节前脱位:1 例报告。

Bilateral anterior shoulder dislocation: A case report.

机构信息

Ministry of Health Sakarya Yenikent State Hospital, Sakarya-Türkiye.

出版信息

Ulus Travma Acil Cerrahi Derg. 2024 Oct;30(10):761-763. doi: 10.14744/tjtes.2024.84935.

Abstract

Bilateral anterior shoulder dislocation (BASD) is a rare condition typically associated with a history of trauma. This case report presents a patient with BASD resulting from trauma and discusses treatment options. A 51-year-old male patient was admitted to the emergency department following a fall from a height. Radiographic examination revealed BASD and a comminuted intra-articular fracture of the distal end of the left radius. The patient did not have any other additional pathologies. After a preoperative evaluation, the patient was urgently taken to the operating room, where both shoulders underwent reduction using the Hippocratic maneuver under sedation anesthesia. Immediately after this procedure, the left wrist was reduced closed, and a penning-type external fixator was inserted under fluoroscopic guidance. Following the reductions, both shoulders were wrapped with a Velpeau bandage and immobilized. An elastic bandage was wrapped around the wrist. By the end of the third week, shoulder mobility exercises were initiated, with a gradual increase in the intensity of the exercises. The wrist fixator was removed in the fifth week after radiographic evaluations, followed by the initiation of passive and then active exercises. Given the rarity of BASD, it is crucial to obtain a detailed clinical history, conduct a comprehensive clinical examination, and perform detailed imaging studies-radiography, computed tomography, and magnetic resonance imaging to avoid overlooking such pathologies in emergency situations. Bilateral anterior shoulder dislocation is a pathology that results from major trauma. It is important to remember that this particular type of pathology may be accompanied by various other pathologies, such as fractures (of the tuberculum majus), rotator cuff injuries, and neurovascular injuries.

摘要

双侧肩关节前脱位(Bilateral anterior shoulder dislocation,BASD)是一种罕见的病症,通常与创伤史有关。本病例报告介绍了一例因创伤导致的 BASD 患者,并讨论了治疗选择。一名 51 岁男性患者从高处坠落后来到急诊科。影像学检查显示双侧肩关节前脱位和左侧桡骨远端关节内粉碎性骨折。患者没有其他任何合并症。经过术前评估,患者被紧急送往手术室,在镇静麻醉下使用 Hippocratic 手法复位双侧肩关节。该操作完成后,立即闭合复位左侧腕关节,并在透视引导下插入 Pennig 式外固定架。复位后,双侧肩关节用 Velpeau 绷带包扎并固定。腕关节固定器在第 3 周末拆除,随后开始进行肩部活动度锻炼,逐渐增加锻炼强度。第 5 周进行影像学评估后,开始进行被动和主动锻炼。鉴于 BASD 的罕见性,在紧急情况下,获得详细的临床病史、进行全面的临床检查以及进行详细的影像学研究(包括 X 线、CT 和 MRI)以避免忽略此类病变至关重要。双侧肩关节前脱位是由严重创伤引起的一种病理情况。需要记住的是,这种特殊类型的病理情况可能伴有其他各种病理情况,如结节部骨折、肩袖损伤和神经血管损伤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a24c/11622715/0e8116a98a89/TJTES-30-761-g001.jpg

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