鏡視下手術を施行した関節窩骨折を伴う肩関節後方不安定症の一例

概要

論文の詳細を見る
Posterior shoulder instability with bony lesions is uncommon. We experienced a patient with this disorder and applied an arthroscopic procedure. A-16-year-old male suffered shoulder subluxation due to an anterior direct blow to his shoulder in 90° abduction while training for American football. Despite the injury, he immediately returned to training. He suffered a similar injury 6months later, and was thus unable to continue training due to recurrent subluxation,and he visited our hospital. We identified posterior instability of his shoulder by the load and shift test and the posterior jerk test. X-rays and CT showed a posterior glenoid rim fracture which was approximately 20% of the width of the glenoid cavity in size. MRI revealed postrerior labrum detachment from the glenoid with the rim fragment. Anterior components were intact. We considered the fragment to be a posterior osseous Bankart lesion, and performed arthroscopic osseous Bankart repair. We threaded the labrum with the fragment, and fastened it using suture anchors. A sling was used for 3 weeks after surgery. After confirmation of the union by CT, we allowed him to return to playing football. At present, he participates in several sports without anxiety. The JSS shoulder instability score improved from 55 points to 92 points. We describe herein arthroscopic treatment for posterior shoulder instability with a large rim fragment and our patients good short-term results.