陳旧性肩関節前方脱臼骨折に対し観血的治療を行った 1 例

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A 38-year-old man with a past history of epilepsy felt shoulder pain in the morning, but he thought that this pain was usual pain after epilepsy. He had been treated by a bone-setter, however his shoulder pain had not cleared. He visited a hospital almost 2 years after his 1st shoulder pain, radiographs showed fracture dislocation of his shoulder. He visited our hospital. His shoulder active range of motion was 150° forward flexion, 140° abduction, 5° external rotation and S level internal rotation. Manual muscle testing was five levels. After radiographs, CT, and angiographies, he was given an open reduction, the internal fixation used cannulated cancellous bone screws and stabilization used the coracoid transfer (modified Bristows procedure). 16 months after the operation, his shoulder active range of motion became 50° forward flexion, 45° abduction, 45° external rotation and L1 level internal rotation. The Japanese Orthopaedic Associations shoulder score (JOA score) had improved from 58 points preoperatively to 76.5 points postoperatively. We reported a case of chronic unreduced fracture dislocation of the shoulder. It is difficult to reduce when a long time has passed since the dislocation. Our case was performed an open reduction and fixation, but his shoulder range of motion was deteriorated postoperatively. But JOA score was improved.