同种异体肱骨重建联合自体后关节盂增强联合保关节治疗慢性闭锁性后肩关节脱位。

IF 1 4区 医学 Q3 ORTHOPEDICS
Katja Rüttershoff, Doruk Akgün, Philipp Moroder
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引用次数: 1

摘要

慢性后路锁定肩关节脱位治疗困难,通常需要全肩关节置换术。虽然关节保留治疗在年轻患者中更可取,但治疗这种病理的手术技术在文献中很少有描述。本文介绍了一名30岁男性慢性锁定后肩脱位患者的治疗方法,采用联合肱骨异体移植重建和自体后肩关节增强术。用两枚可吸收螺钉固定新鲜冷冻的同种异体股骨移植物,获得球形肱骨头表面的修复。由于肱骨重建术后术中持续的后路不稳定,我们采用自体三皮质髂骨移植物增强后盂,并用两枚金属螺钉固定。在一年的随访中,这种治疗策略使患者活动范围全,肩关节中心稳定。因此,当单纯的肱骨头重建术不能满足年轻患者的需求时,采用新鲜冷冻同种异体骨联合后盂隆骨和髂骨自体移植物进行肱骨头节段性重建术是一种保留关节的治疗方法,可替代肩关节置换术。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Joint Preserving Treatment of Chronic Locked Posterior Shoulder Dislocation by Means of Combined Humeral Allograft Reconstruction and Posterior Glenoid Autograft Augmentation.

Chronic locked posterior shoulder dislocations are challenging to treat and often warrant total shoulder arthroplasty. While joint preserving treatment is preferable in young patients, surgical techniques to treat this pathology have rarely been described in the literature. This technical note presents the treatment of a 30-year-old male patient with a chronic locked posterior shoulder dislocation by means of combined humeral allograft reconstruction and posterior glenoid autograft augmentation. Restoration of the spheric humeral head surface was obtained using a fresh-frozen femoral allograft fixed with two reabsorbable screws. Due to the intraoperatively persistent posterior instability after humeral reconstruction, the posterior glenoid was augmented with a tricortical iliac crest autograft, which was fixed with two metal screws. This treatment strategy resulted in a full range of motion and a centered stable shoulder joint at one-year follow-up. Therefore, the procedure of segmental reconstruction of the humeral head with a fresh-frozen allograft combined with a posterior glenoid augmentation with an iliac crest bone autograft is a joint-preserving treatment alternative to shoulder arthroplasty in young patients when humeral head reconstruction alone does not suffice.

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来源期刊
CiteScore
1.80
自引率
10.00%
发文量
102
期刊介绍: Das Forum für Orthopädie und Unfallchirurgie aus einer Hand Aktuelles aus Klinik, Wissenschaft und Forschung Ein unabhängiges Peer-Review-Verfahren sichert Qualität, Relevanz und Plausibilität der Daten Modernes Layout: Klare Gliederung, farbige Abbildungen, strukturierte Tabellen Orthopädie und Unfallchirurgie aktuell: Berichte und Reportagen zu den wichtigsten Themen im Fach
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