Ogawa K, Yoshida A
Department of Orthopedic Surgery, School of Medicine, Keio University, Tokyo, Japan.
J Shoulder Elbow Surg. 1997 Jan-Feb;6(1):1-5. doi: 10.1016/s1058-2746(97)90063-x.
Anterior capsular and ligamentous injuries occur frequently at initial traumatic shoulder dislocation. However, these injuries have not been considered to be one of the main causes of recurrent anterior dislocation, which is believed to heal spontaneously. We evaluated five joints of five patients in which tears in the middle portion of the anterior capsule including the inferior glenohumeral ligament were considered to be the main cause of recurrent dislocation. History of present illness and physical and plain x-ray results were not specific. The only specific finding was a diverticulum-like expansion at the anteroinferior portion of the joint on arthrographic computed tomography. Treatment consisted of anatomic repair of the capsule and concurrent injuries. The outcome of the three cases in which at least 2 years had passed after surgery was excellent. The point of emphasis is that tears of the anterior capsule are one of the primary lesions in recurrent anterior dislocation.
初次创伤性肩关节脱位时,前囊和韧带损伤很常见。然而,这些损伤一直未被视为复发性前脱位的主要原因之一,人们认为其可自发愈合。我们评估了5例患者的5个关节,其中前囊中部包括肩胛下韧带的撕裂被认为是复发性脱位的主要原因。现病史、体格检查及普通X线检查结果均无特异性。唯一的特异性表现是关节造影CT显示关节前下部有憩室样扩张。治疗包括对关节囊及并发损伤进行解剖修复。术后至少随访2年的3例患者效果良好。重点在于,前关节囊撕裂是复发性前脱位的主要病变之一。