Neglected Traumatic Locked Anterior Shoulder Fracture-Dislocation

Anterior omuz çıkıkları, acil serviste en sık karşılaşılan ve beraberinde proksimal humerus kırıklarının da eşlik edebildiği eklem çıkıklarıdır. İzole çıkıklar, akut dönemde kapalı yöntemlerle kolayca tedavi edilebilmelerine rağmen, gecikmiş olgularda, beraberinde kırık eşlik ediyorsa tedavi daha zor hale gelmektedir. Bu yazıda, travma sonrası omzunda kilitli, kırıklı-çıkık oluşan 22 yaşındaki hasta sunuldu. Yaralanmanın üzerinde 3 hafta geçmiş olması ve humerus başının glenoidin anterior dudağında kilitlenmiş olmasından dolayı hastaya açık redüksiyon ve plak vida ile internal tespit uygulandı. Altı ay sonra yapılan kontrolünde kırığın kaynadığı ve avasküler nekrozun gelişmediği görüldü. İhmal edilmiş kilitli omuz kırıklı çıkıkları avasküler nekroz riski göz önünde bulundurularak açık redüksiyon ve internal tespit ile tedavi edilmelidir

Neglected Traumatic Locked Anterior Shoulder Fracture-Dislocation

Anterior shoulder dislocations are the most common major joint dislocations encountered in the emergency departments and fractures of proximal humerus can accompany with dislocations. Although the treatment of acute isolated traumatic anterior shoulder dislocation is generally simple, the treatment of neglected fracture-dislocations becomes more complicated. In this report, a 22-year-old male patient who had posttraumatic locked, shoulder fracture-dislocation is presented. Open reduction and internal fixation was performed because the injury had occurred 3 weeks ago and the humeral head was locked on the anterior rim of glenoid. At sixth month post-operative follow-up, it was seen that the fracture had united and there was no radiological evidence of avascular necrosis. Neglected, locked anterior fracture-dislocations should be managed thoughtfully by open reduction and internal fixation with consideration of the risk for avascular necrosis.

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  • Abdelhady AM. Neglected anterior shoulder dislocation: open remplissage of the Hill-Sachs lesion with the infra- spinatus tendon. Acta Orthop Belg 2010; 76:162-5.
  • Robinson CM, Shur N, Sharpe T, Ray A, Murray IR. Injuries associated with traumatic anterior glenohumeral disloca- tions. J Bone Joint Surg Am 2012; 94:18-26.
  • Checchia SL, Santos PD, Miyazaki AN. Surgical treatment of acute and chronic posterior fracture-dislocation of the shoulder. J Shoulder Elbow Surg 1998 ;7:53-65.
  • Chalidis BE, Papadopoulos PP, Dimitriou CG. Reconstruction of a missed posterior locked shoulder fracture-dislocation with bone graft and lesser tuberosity transfer: a case re- port. J Med Case Rep 2008 ;2:260.
  • Dodds SD, Medvecky MJ. Chronic bilateral locked anterior shoulder fracture-dislocations. Am J Orthop (Belle Mead NJ) 2008 ;37:364-8.
  • Thomas DP, Graham GP. Missed bilateral anterior fracture dislocations of the shoulder. Injury 1996 ;27:661-2.
European Journal of General Medicine-Cover
  • Başlangıç: 2015
  • Yayıncı: Sağlık Bilimleri Araştırmaları Derneği
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