Arthroscopic surgery in cases with an aging locked posterior dislocation of the shoulder
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Дата
2012-04
Автори
Dimitrov, N.
Tsekov, P.
Matev, B.
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Издател
Централна медицинска библиотека, МУ София / Central Medical Library - MU Sofia
Резюме
The shoulder joint is most vulnerable to dislocation. Anterior dislocation
is common, while the posterior one is very rare – about 4% of all dislocations
of the shoulder. Because of this, the diagnosis is frequently missed at the initial examination
– McLaughlin called the situation a “diagnostic trap”. The surgical treatment
of posterior dislocations initially aimed at reduction of the joint. However, this
is not suffi cient for aging dislocations. Stability is to be provided. In recent years,
the promotion of arthroscopic treatment is becoming increasingly important, especially
given for its indisputable advantages. In the Department of Surgery of the
Upper Limb in the University Specialized Hospital for Active Treatment in Orthopedics
USHATO – “Prof. B. Boychev” for the period 2005-2011, were operated 12
patients (8 men and 4 women – a total of 12 shoulders). All had persistent posterior
dislocation of the shoulder as a result of injury, after a lapse of between 3 and 8
months – an average of 4.5 months. In all cases an osteohondral defect from 25 to
45% (average 30%) located on the front surface of the head of the humerus was
set. Surgery: Seven patients were fi rst operated through arthroscopic reduction
and then stability was restored by transposition of m.subscapularis in the osteohondral
defect. Five patients were operated without prior arthroscopic reduction – only
through open surgery. Follow-up period was from 6 months to 6 years (3 years
averagely). The reported results indicate that abduction, fl exion and internal rotation
increased much more rapidly and to a larger volume in patients in which fi rst
arthroscopic reduction was made, compared with those where it was held via conventional
surgery, due to its larger volume and greater operational trauma. These
results were also confi rmed using two post-operative function of the shoulder joint
scoring systems: Murley Constant Score and UCLA.
Описание
Address for correspondence:
B. Matev, DM
Clinic of Surgery fo the Upper Limb
USHATO − "Prof. B. Boychev"
56 Nikola Petkov blvd.;
1614 Sofi a, Bulgaria;
tel.: 02/81-81-622;
mobile tel.:0888 46 11 75;
e-mail: bimatev@abv.bg
Ключови думи
posterior locked luxation of the shoulder, arthroscopic-assisted reduction, stability
Цитирания
N. Dimitrov, P. Tsekov and B. Matev. Arthroscopic surgery in cases with an aging locked posterior dislocation of the shoulder - Acta medica bulgarica , 39, 2012, No 1, 104-119.