肩関節前方脱臼に伴う大結節裂離骨折に対する鏡視下手術の 2 例

抄録

We presented an arthroscopic fixation technique for 2 patients with avulsion fracture of the greater tuberosity(GT) associated with anterior dislocation of the shoulder. (Case 1) A 66-years-old woman was injured when she hit the ground on her right shoulder. She had been diagnosed with anterior shoulder dislocation and had a closed reduction. 12 days after her injury, she visited our hospital. X-rays revealed a 20mm-upper displacement of avulsion fracture of GT. 18 days after her injury, an arthroscopic operation was performed. Anterior labrum had fissure but not detachment from the anterior glenoid rim. The tension of AIGHL was good. The upper side of SSC tendon was partial rupture. We performed an arthroscopic repair of partial SSC tear using 1 anchor and the arthroscopic fixation of avulsion fracture of GT using 3 anchors (suture bridging technique). (Case2) A 68-years-old woman was injured when she hit the ground on her left shoulder. She had been diagnosed with anterior shoulder dislocation and had a closed reduction. 13 days after her injury, she visited our hospital. X-rays revealed a 10mm-upper displacement of avulsion fracture of GT. 17 days after her injury, an arthroscopic operation was performed. There were no Bankart lesion, capsular tear or SSC tendon rupture. We performed the arthroscopic fixation of avulsion fracture of GT using 3 anchors (suture bridging technique). Arthroscopic fixation was an effective method for avulsion fracture of GT and then for reconstructing other lesions associated with shoulder dislocation. At the anchor fixation, we should be careful of loosening of the anchor due to fragile bone.