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Rehabilitation Practice and Science

Translated Title

肩盂肱骨關節脫臼合併腋神經損傷及肩旋轉帶破裂：病例報告暨文獻回顧

Abstract

Dislocation of the glenohumeral joint is a frequent disorder that occurs among traumatic injuries of the shoulder. There are differences in the dislocation between young and older patients. Recurrent instability is more common to follow traumatic anterior dislocation of the glenohumeral joint in young patients than older patients. Neurologic complications and associated soft tissue injuries after a glenohumeral dislocation occur more frequently in patients around 40 years of age and older.A 73-year-old patient suffered from dislocation of left glenohumeral joint after falling down. Paralysis of left shoulder muscle was found after the close reduction. Physical examinations disclosed loss of active range of motion of left shoulder in the position of anterior flexion, abduction and external rotation. Decreased muscle power of left shoulder in extension was also found. The active range of motion of left shoulder in internal rotation and adduction was normal. The active range of motion of left shoulder girdle and elbow was also normal. There was neither pain nor painful arc during motion. Painless weakness of left shoulder was noted in anterior flexion, abduction and external rotation. Magnetic resonance imaging of left shoulder disclosed massive tears of the rotator cuff (the supraspinatus and the infraspinatus tendons). Nerve conduction velocity and electromyogram studies revealed axillary nerve injury, which resulted in complete paralysis of deltoid and teres minor. Rotator cuff tears together with axillary nerve injury after dislocation of the glenohuermal joint have been documented in the medical literatures. Early surgical intervention seems to have a good outcome to treat rotator cuff tears, even a variable reported prognosis for axillary nerve recovery. This casereport aims at reminding the clinician how to manage complications after dislocation of the glenohumeral joint. In the meanwhile, the occurrence of rotator cuff tears with axillary nerve injury after dislocation of the glenohumeral joint was reviewed.

Language

Traditional Chinese

First Page

167

Last Page

176

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