陳旧性肩関節脱臼[骨折]に対する人工骨頭 • 人工関節置換術

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Background: The treatment of chronic unreduced dislocation of the shoulder is a difficult case in shoulder surgery. The purpose of this study is to investigate clinical results of surgical treatments for chronic unreduced dislocation of the shoulder by implants. Methods: 10 shoulders of 10 patients were studied. The average age at the time of the surgery was 60 (range: 34 to 89) years old. The period from trauma to surgery ranged from 3 months to 34 years. We investigated the surgical approach, operative findings, complications and postoperative results by JOA score. Results: Six cases were treated by hemi shoulder arthroplasty and four cases by total shoulder arthroplasty. The surgical approach was combined anterior and posterior in 2 out of 4 cases of chronic unreduced posterior dislocation. For chronic unreduced anterior dislocation, the surgical approach was only anterior. We repaired the bone defect of the scapula by bone graft in six cases. In all cases, pain was reduced and the shoulder joint was reduced. The average JOA score improved from 25 points preoperatively to 78 points postoperatively. Conclusion: When we treat chronic unreduced dislocation of the shoulder surgically, we have to pay great attention to both soft tissues and bones. The combined approach from anterior and posterior is useful for chronic unreduced posterior dislocation. Posterior capsule release is very important for chronic unreduced anterior dislocation. We have to repair the bone defect of the articular surface of the scapula.

陳旧性肩関節脱臼[骨折]に対する人工骨頭 • 人工関節置換術

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