改良麦克劳克林手术治疗被忽视的肩后脱位。

Alessandro Castagna, Giacomo Delle Rose, Mario Borroni, Nikolaos Markopoulos, Marco Conti, Leonardo Maradei, Raffaele Garofalo
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引用次数: 34

摘要

肩后脱位是一种罕见的损伤,通常发生在高能量创伤后。不幸的是,诊断通常被遗漏,因此使其治疗成为一个挑战。被忽视的后路脱位主要表现为肱骨头前关节面印痕骨折,这使得脱位通常难以复位。诊断是基于仔细的病史评估,体格检查和放射检查结果。已经描述了几种治疗方法。我们手上改良的麦克劳克林手术已被证明是一种可重复的技术,在中期和长期随访中可以获得良好的结果。根据我们的经验,对于年龄大于6个月的后路锁定脱位患者,或者肩关节假体不适合时肱骨头缺损达50%的患者,也可以采用该技术。伴有肱骨近端骨折的患者预后较差。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Modified MacLaughlin procedure in the treatment of neglected posterior dislocation of the shoulder.

Posterior dislocation of the shoulder is an unusual injury that most often occurs secondary to a high-energy trauma. Unfortunately the diagnosis is commonly missed, thus making its treatment a challenge. Neglected posterior dislocation is mainly characterised by an impression fracture on the anterior articular surface of the humeral head, which makes the dislocation often difficult to reduce. Diagnosis is based upon a careful history assessment, physical examination and radiological findings. Several treatment approaches have been described. The modified MacLaughlin procedure in our hands has been shown to be a reproducible technique allowing good results at medium- and long-term follow-up. According to our experience it is possible to adopt this technique also in patients with a locked posterior dislocation older than 6 months or in cases with a humeral head defect up to 50% when a shoulder prosthesis is not a good indication. Poorer results should be expected in patients with an associated fracture of the proximal humerus.

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