関節窩骨折を伴った肩関節脱臼に対するＮ‐Ｈ法の経験

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A case of the treatment for dislocation of the shoulder with glenoid fractures repaired by N-H method is reported here. The patient was a 34-year-old man who injured his shoulder when he fell down while snowboarding. He reduced his shoulder by himself. Next day he visited our outpatient clinic and the roentgenograms showed the glenoid fracture and greater tuberosity fracture. In CT, anterior glenoid fracture was large of which the body occupied 22% of that (Hitachi medico H-premium). The greater tuberosity fracture had no displacement. Surgery was carried out to remove the patient's suffering. Anterior and anteroinferior instability was confirmed. EUA Arthroscopic examination revealed labrum tear from 7 to 12 o'clock, ruptured MGHL, the elongated joint capsule, and AIGHL as the diagnosis in CT. N-H method was performed. The findings obtained during the operation were similarly to those mentioned. After operation, to gain a normal ROM and sufficient muscle strength, passive, active, and resistant exercises were started after three weeks. Postoperative 4months, the union of the glenoid fracture was completed in CT. Because the N-H method aimed at the reconstruction of the elongated anteroinferior capsule supplemented by a double breasting of the anterior wall of the joint using the subscapularis tendon, fracture of the body could gain stability and union. It may be difficult to gain the same result with arthroscope unless using screw or anchor. The N-H method is useful for fracture-dislocations of the shoulder without internal fixation to gain stability and union.

関節窩骨折を伴った肩関節脱臼に対するＮ‐Ｈ法の経験

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