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关节镜稳定技术治疗合并喙突双骨折的肩锁关节脱位延迟就诊:1例报告

Late Presentation of Acromioclavicular Joint Dislocation with Double Fracture of Coracoid Process Managed by Arthroscopic Stabilization Technique: A Case Report.

作者信息

Somasundaram Anand Kumaroth, Mohan Aiswarya, Appukuttan Anjali

机构信息

Department of Orthopaedics, Caritas Hospital and Institute of Health Sciences, Kottayam, Kerala, India.

Department of Research And Biostatistics, Research and Development Cell, Caritas Hospital and Institute of Health Sciences, Kottayam, Kerala, India.

出版信息

J Orthop Case Rep. 2025 Jul;15(7):78-83. doi: 10.13107/jocr.2025.v15.i07.5774.

Abstract

INTRODUCTION

Acromioclavicular joint (ACJ) dislocation associated with coracoid process fracture is an uncommon injury. Herein, we report a case with such a combination of injuries. This is the first reported case of its kind to be managed with an arthroscopic technique.

CASE REPORT

A 48-year-old female was injured by a direct fall on her right shoulder. Initial conservative management failed, which led to persistent pain and functional impairment. A late diagnosis of ACJ dislocation was made, necessitating surgical intervention. The patient was successfully treated using an arthroscopically assisted stabilization technique with tendon graft augmentation and an arthroscopic repair of a superior labral tear, which was diagnosed intraoperatively. Post-operative outcomes were favorable, showing the efficacy of this approach for managing such complex shoulder injuries.

CONCLUSION

This case signifies the importance of early detection of concomitant injuries of the superior shoulder suspensory complex in high-velocity ACJ injuries, which, when not diagnosed timely, necessitate complex surgical procedures later. This also highlights the possibility of minimally invasive arthroscopic techniques for managing late presentation of such an injury.

摘要

引言

肩锁关节(ACJ)脱位合并喙突骨折是一种罕见的损伤。在此,我们报告一例此类合并损伤的病例。这是首例采用关节镜技术治疗的此类病例。

病例报告

一名48岁女性因右肩部直接着地受伤。最初的保守治疗失败,导致持续疼痛和功能障碍。晚期诊断为肩锁关节脱位,需要手术干预。患者采用关节镜辅助稳定技术,并用肌腱移植加强,并对术中诊断出的上盂唇撕裂进行关节镜修复,成功得到治疗。术后结果良好,表明该方法治疗此类复杂肩部损伤的有效性。

结论

该病例表明,在高速肩锁关节损伤中早期发现肩上部悬吊复合体合并损伤非常重要,若未及时诊断,后期需要进行复杂的手术。这也凸显了采用微创关节镜技术治疗此类损伤晚期表现的可能性。

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