Armada Lucas, Amaro Pedro, Alonso Raul, Pires Luís
Hospital Beatriz Ângelo, Lisbon, Portugal.
Hospital da Luz de Lisboa, Lisbon, Portugal.
Trauma Case Rep. 2025 Apr 15;57:101180. doi: 10.1016/j.tcr.2025.101180. eCollection 2025 May.
Proximal humerus fracture-dislocations are complex injuries, particularly when there is extensive bone loss, compromised soft tissues, or failed initial treatment. We present the case of a 23-year-old male with a chronic shoulder fracture-dislocation following a fall. Initial management involved open reduction and internal fixation, but postoperative imaging revealed hardware failure and recurrent shoulder dislocation. The patient then underwent humeral head reconstruction using an iliac crest autograft. However, two months later, subluxation and humeral head necrosis were detected. A second reconstruction was performed using a proximal humerus allograft, which successfully restored shoulder stability and function. This case highlights the effectiveness of allogenic bone reconstruction in managing complex shoulder injuries.
肱骨近端骨折脱位是复杂的损伤,尤其是当存在广泛骨质丢失、软组织受损或初始治疗失败时。我们报告一例23岁男性患者,其在跌倒后出现慢性肩部骨折脱位。初始治疗包括切开复位内固定,但术后影像学检查显示内固定失败且肩关节反复脱位。该患者随后使用自体髂骨移植进行肱骨头重建。然而,两个月后,发现半脱位和肱骨头坏死。第二次重建使用了肱骨近端异体骨移植,成功恢复了肩关节的稳定性和功能。该病例突出了同种异体骨重建在处理复杂肩部损伤中的有效性。