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肩关节新鲜性和习惯性脱位(作者译)

[Fresh and habitual dislocation of the shoulder joint (author's transl)].

作者信息

Wissing H

出版信息

Unfallchirurgie. 1980;6(4):233-8. doi: 10.1007/BF02589472.

Abstract

In case of the most common anterior-inferior dislocation of the shoulder joint the humeral head is forced out of the glenoidal cavity and tears the capsule. In about 20% of cases the dislocation is complicated by tears of the rotatory cuff, avulsion fractures and lesions of vessels and nerves. Reduction as soon as possible according to the method of Arlt or Hippokrates is recommended to avoid further damage. X-ray examination in 2 directions is necessary to confirm the position of the head. Clinical examination must be done to detect lesions of nerves or vessels caused by the procedure. In cases of recurrent dislocation a Hill-Sachs lesion and/or a Bankart lesion is responsible for instability of the shoulder joint. The elevation of the margin of the glenoid by autologous bone grafting (Eden-Hybinette, Trillat) and/or the derotation of the humeral head (Weber) reliably avoids redislocation. Except rare infections no severe complications are known. The operative correction of the severe disability should be recommended to all patients suffering from recurrent dislocation of shoulder joint.

摘要

在肩关节最常见的前下脱位病例中,肱骨头被强行脱出关节盂并撕裂关节囊。约20%的病例中,脱位会并发肩袖撕裂、撕脱骨折以及血管和神经损伤。建议尽快按照阿尔特法或希波克拉底法进行复位,以避免进一步损伤。需要进行两个方向的X线检查以确认肱骨头的位置。必须进行临床检查以检测该操作引起的神经或血管损伤。在复发性脱位的病例中,希尔-萨克斯损伤和/或班卡特损伤是肩关节不稳定的原因。通过自体骨移植抬高关节盂边缘(伊登-希比内特法、特里拉特法)和/或肱骨头旋转(韦伯法)可可靠地避免再次脱位。除了罕见的感染外,尚无严重并发症的报道。对于所有患有复发性肩关节脱位的患者,均应建议进行手术矫正严重残疾。

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