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Open anterior glenohumeral dislocation with associated supraspinatus avulsion: A case report

World Journal of Clinical Cases 2019年第7期7卷 849-854页

作者： Cosmin Ioan Faur bogdan anglitoiu Ana-Maria Ungureanu 2~(nd) Department of Orthopaedics and Traumatology University of Medicine and Pharmacy "Victor Babes" Department of Radiology and Medical Imaging University of Medicine and Pharmacy "Victor Babes"

BACKGROUND Open dislocation of the glenohumeral joint is a very rare complication with only six cases described in the literature. Most cases resulted in severe complications like avascular necrosis of the humeral head or septic arthritis with poor functional results. The "mandatory" treatment of choice is surgery, with accurate debridement and reconstruction of the damaged soft tissues. However, the results in these cases do not approach those seen in classical *** SUMMARY This case report is the first description of an anterior open glenohumeral dislocation without associated fractures, but with complete avulsion of the soft tissue envelope of the proximal humerus. Surgical treatment consisted of copious lavage with saline solution, meticulous debridement of the nonviable soft tissues,reduction of the dislocated humeral head and reconstruction of the soft tissue envelope of the humeral head. The selected surgical approach was an inferior extension of the wound at the level of the delto-pectoral groove, as the best choice to be able to perform an adequate debridement and capsulo-tendinous reinsertion. At 6 mo there were no clinical signs of instability of the glenohumeral joint, the functionality of the joint was restricted to 90o of anterior elevation,internal rotation to L2, with severe limitation of abduction(60o) and external rotation(0o) but without residual pain, with an Oxford shoulder Score of *** Thorough reconstruction of the soft tissues surrounding the shoulder joint and an early rehabilitation program are key points to a good functional result.

关键词： Open shoulder dislocation Case report Functional impairment Surgical treatment Avascular necrosis

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