三角筋拘縮症に合併した反復性肩関節脱臼の1例

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The subject in this study was a 35-year-old male, who was right handed. When he was 23 years old, he fell down while skiing and dislocated his left shoulder. After he reduced his shoulder by himself, he had not felt any feeling of instability.When he was 34 years old, he dislocated his left shoulder in an abducted and extended position. After that, he suffered from recurrent dislocation of his left shoulder. At physical examination, a hard band, 1cm wide, was palpable within the deltoid and winged scapula was caused by abduction contracture. Furthermore, he had a limited range of motion for external rotation and horizontal adduction, and positive anterior apprehension sign. X-ray showed slight flattening of the humeral head and deformity of the acromion. MRI revealed a fibrous band within the intermediate part of the deltoid. Because CT-arthrogram demonstrated there was the bony Bankart lesion, we performed arthroscopic Bankart repair. After 4 years, the JSS score improved from 49 to 90 points, and the Rowe score from 15 to 90 points. There has been no recurrence of the dislocation in the meanwhile.Spontaneous dislocation and subluxation of the shoulder can occur after deltoid contracture. It is suggested that a fibrous band fixes the shoulder in abducted and extended position with the patient standing and the band converts the weight of the arm into force that move the humerus head in the anterosuperior direction. For the severe deltoid contracture, release of the contracture band is required. Although the result of arthroscopic Bankart repair for this case was favorable, further observation will be needed.

三角筋拘縮症に合併した反復性肩関節脱臼の1例

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