肩甲下筋断裂を伴い受傷後短期間に反復性となった肩関節前方脱臼の 1 例
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概要
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We report on a young adult case of short-term formed recurrent anterior shouder dislocation after trauma associated with subscaplaris muscle rupture. There was no history of an underlying pathological condition and no history of shouder subluxation or dislocation. A 26-year-old male Japan Ground Self-Defense Force soldier experienced severe pain of his left soulder in an attempt to catch ivy during ranger training on the wall, but he got a feeling of reduction shortly after self-manipulation and continued to training. Four days after the initial subluxation, he couldnt tolerate the increased pain and dislocation occurred more than 10 times. He consulted our clinic 5 days after injury. AP radiograph showed inferior displacement of the left humeral head associated with a large Hill-Sachs lesion. Plain CT showed antero-inferior bony defect of the glenoid and numerous bony fragments. In MRI, partial rupture of the subscaplaris muscle belly and detachment of the antero-inferior labrum were observed, but there was no rotator cuff injury. Because of the treatment of the cellulites and the subscaplaris muscle rupture, Latarjet operation was performed 1 month after injury. And the intraoperative findings coincided with those of the preoperative imaging. At 15-month follow up, he had no pain and his shoulder ROM returned to normal. In this case, both midsubstance rupture of the subscaplaris muscle and the continuing the ranger training may subacutely cause the recurrent, traumatic shoulder dislocation.
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