Cheng S L, Mackay M B, Richards R R
Upper Extremity Reconstructive Service, St. Michael's Hospital, Toronto, Ontario, Canada.
J Shoulder Elbow Surg. 1997 Jan-Feb;6(1):11-7. doi: 10.1016/s1058-2746(97)90065-3.
Total shoulder arthroplasty is indicated in the treatment of locked posterior fracture-dislocations of the shoulder where there is extensive damage to the articular surfaces of the humerus and glenoid. This report reviews the surgical technique, postoperative rehabilitation program, and functional results of seven shoulders in five patients who had locked posterior dislocations of the shoulder. Activities involving overhead positioning of the arm and heavy lifting continued to be challenging for this group of patients. The American Shoulder and Elbow Surgeons' Shoulder Score improved from 20.1 before surgery to 55.6 after surgery (p = 0.018). The extrication of the posteriorly dislocated humeral head may be difficult from an anterior deltopectoral approach. The authors describe the use of a secondary posterior incision facilitating the extrication of the humeral head. In this series total shoulder arthroplasty reliably decreased the patients' level of pain, improved their range of motion, and significantly improved their level of function.
全肩关节置换术适用于治疗肩关节后脱位并伴有肱骨和肩胛骨关节面广泛损伤的情况。本报告回顾了5例患者7个肩关节的手术技术、术后康复计划及功能结果，这些患者均患有肩关节后脱位。对于这组患者而言，涉及手臂过顶定位和重物举升的活动仍然具有挑战性。美国肩肘外科医师协会的肩关节评分从术前的20.1提高到术后的55.6（p = 0.018）。采用前侧三角肌胸大肌入路可能难以将后脱位的肱骨头复位。作者描述了使用辅助后外侧切口来促进肱骨头复位。在本系列研究中，全肩关节置换术确实降低了患者的疼痛程度，改善了活动范围，并显著提高了功能水平。
