Checchia S L, Santos P D, Miyazaki A N
Department of Orthopedics, School of Medicine, Santa Casa Hospitals.
J Shoulder Elbow Surg. 1998 Jan-Feb;7(1):53-65. doi: 10.1016/s1058-2746(98)90183-5.
Seventy-three shoulders (66 patients) with posterior fracture-dislocation of the shoulder were treated. Thirty patients were treated during the acute phase. One case was classified as subspinous, and 56 were considered subacromial; 4 cases had posterior fracture-dislocation in three parts, 3 in four parts, and 9 at the anatomic neck. Treatment consisted of closed reduction and immobilization in the emergency department, McLaughlin's procedure, hemiarthroplasty, total shoulder, open reduction with internal fixation, arthroplastic resection, and arthrodesis. Ten shoulders were treated conservatively. The University of California-Los Angeles rating score was used to analyze 56 shoulders during a mean follow-up period of 32.7 months. Good and excellent results can be achieved in those cases that are treated up to 2 years of the lesion; after 2 years results tend to be fair. We do not suggest total shoulder arthroplasty as a treatment option for those surgeons without the necessary expertise.
对73例（66名患者）肩关节后脱位骨折进行了治疗。30例患者在急性期接受治疗。1例为棘下型，56例为肩峰下型；4例为三部分后脱位骨折，3例为四部分后脱位骨折，9例为解剖颈骨折。治疗方法包括在急诊科进行闭合复位和固定、麦克劳林手术、半关节成形术、全肩关节置换术、切开复位内固定、关节成形切除术和关节融合术。10例肩关节采用保守治疗。采用加州大学洛杉矶分校评分系统对56例肩关节进行平均32.7个月的随访分析。在损伤后2年内接受治疗的病例可取得良好和优异的效果；2年后效果往往一般。对于没有必要专业技能的外科医生，我们不建议将全肩关节置换术作为一种治疗选择。
