Bankart lesion と HAGL lesion を同時に関節鏡視下に修復した 1 例
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We report a case of recurrent anterior glenohumeral joint instability with a combined Bankart and humeral avulsion of the glenohumeral ligament (HAGL) lesion, both repaired arthroscopically. The patient was a 14-year-old male, right-handed baseball outfielder. He first dislocated his left shoulder when he pushed a heavy burden. Although he was aware of his recurrent dislocation, his shoulder was left untreated due to frequent spontaneous reduction. Just before his visit to our hospital, he redislocated his shoulder during a baseball game and was unable to reduce it by himself. He tested positive for the anterior apprehension test with anterior instability. CT examination showed a Hill-Sachs lesion and normal appearance of glenoid morphology. After an injection of lidocaine into the glenohumeral joint, MRI evaluation confirmed a Bankart lesion and an enlarged axillary pouch. We arthroscopically identified a HAGL lesion and created 5- and 7-o'clock portals. Two suture anchors were utilized to repair the lesion by attaching the border of the articular capsule to the humeral neck. The Bankart lesion was then repaired, followed by an RI-closure. We allowed gentle assistive exercise after four weeks of immobilization. He returned to baseball five months after repair. At 18-months after surgery, the JOA-SS was 100 points and JSS-SIS was 97. The external rotation range decreased 20-degrees in arm at side; however, no redislocation had occurred and no instability was seen. Performing arthroscopic repair of both lesions with an RI-closure provided good results. MRI after lidocaine injection was useful for pre-operative evaluation.
- 日本肩関節学会の論文
日本肩関節学会 | 論文
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