保存的に治療した肩関節下方脱臼骨折の一例

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Inferior dislocation of the shoulder joint is relatively rare, has been reported to be only 0.5% of the total of dislocations of the shoulder. We report on a large depressed fracture of the humeral head (Hill-Sachs like lesion) cased by dislocation of the shoulder joint inferiorly , and discuss it's treatment.<BR>A 46-year-old man, in the transportation industry Fell from the back of a truck and injured, his right shoulder. On X-ray, humeral head was dislocated to the inferior of the glenoid, and had a depressed fracture. Manual reduction was done at another hospital, the next day, he visited our hospital. Neurovascular injury symptoms were not present. Collapse of the humeral head occurred during anterior dislocation of the shoulder Hill-Sachs like lesion, in total lateral 2cm, rang in depth was 1cm. There was no Bankart like lision on the glenoid cavity. After one week, in X-ray taken under stress, inferior instability was minimal; fracture compliance was good for the glenoid cavity in abduction position. Therefore, conservative treatment was continued.<BR>After 1 year, the JOA score was 100 points. X-ray, of the depressed fracture of the humerus showed union, and no change in osteoarthritis. Inferior instability of the shoulder was not seen. The MRI showed no rotator cuff tear, and no labrum damage.<BR>The present case is a large Hill-Sachs like lesion showed whether or not surgical fixation of a depressed fracture is needed, there has been no detailed report about this in the past. Good results were obtained selecting conservative treatment.

保存的に治療した肩関節下方脱臼骨折の一例

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