Wirth M A, Seltzer D G, Rockwood C A
Department of Orthopaedics, University of Texas Health Science Center at San Antonio 78284-7774.
Clin Orthop Relat Res. 1994 Nov(308):98-101.
Recurrent traumatic posterior glenohumeral dislocation is rare and probably represents < 5% of all recurrent shoulder instability cases. Operative management of this problem is considered when symptomatic recurrent instability occurs despite an adequate physician-directed rehabilitation program. Before surgery, it is essential to recognize all directions of instability and any anatomic factors that may predispose the shoulder to recurrent instability, such as humeral head or glenoid defects, abnormal glenoid version or other anthropomorphic abnormalities, rotator cuff tears, neurologic injuries, or generalized ligamentous laxity. The authors report on a patient who had 2 previous failed attempts at posterior capsulorrhaphy for recurrent posterior shoulder dislocation after an atraumatic injury. The patient demonstrated a previously unrecognized unilateral increase in glenoid fossa retroversion and was successfully treated with a posterior opening wedge osteotomy of the scapular neck.
复发性创伤性肩肱关节后脱位较为罕见，可能占所有复发性肩关节不稳病例的不到5%。尽管有医生指导的充分康复计划，但当出现有症状的复发性不稳时，才考虑对该问题进行手术治疗。手术前，必须识别所有方向的不稳以及任何可能使肩关节易发生复发性不稳的解剖因素，如肱骨头或关节盂缺损、关节盂形态异常或其他人体形态学异常、肩袖撕裂、神经损伤或全身性韧带松弛。作者报告了一名患者，该患者此前因非创伤性损伤导致复发性肩关节后脱位，曾两次进行后路关节囊缝合术均失败。该患者表现出先前未被认识到的关节盂窝后倾单侧增加，并通过肩胛颈后路开放楔形截骨术成功治愈。
