持続性肩関節前方亜脱臼の2例

抄録

Two cases of sustained anterior subluxation of the shoulder joint were treated operatively.
Case 1: A 14-year-old girl. On Oct.7th 1985, she noticed pain in her left shoulder after doing chin exercises.
A doctor diagnosed anterior subluxation of the shoolder, and fixed her left arm with a Desarlt bandage. But, she was unable to sustain the reduced position. Then another doctor applied a shoulder spica cast in the abducted position for 3 weeks. After removal of the cast deformity of the left shoulder was recognized. On her first visit to Matsudo orthopaedic hospital on Nov.13th 1985, anterior subluxation of the left shoulder was certified by CT scans. Remarkably multidirectional shoulder instability was also noticed. Reduction was easily obtained by external rotation of the shoulder, but the humeral head displaced forwardly in the dependent position. On Dec.10th 1985, Protzman's and modified Bristow's procedures were performed. After Surgery, the arm was fixed with transarticular pins and a Velpeau bandage for 3 weeks.2 years after surgery, external rotation of the shoulder was 55°, but she had neither disabilities nor anxieties.
Case 2: An 11-year old girl. On June 1987, deformity of the right shoulder appeared without any movent. On her first visit to Matsudo orthopaedic hospital on July 15th 1987, anterior subluxation of the right shoulder was certified. Remarkable outward slipping of the humerus was noticed by roentgenograms taken in the elevated position of the shoulder. It was easily reduced by adduction of the shoulder, but displaced forwardly in the dependent position. On July 30th 1987, a Protzman's a modified Bristow's procedure and a “Rotator interval” repair were performed. After surgery the arm was fixed by transarticular pins and a Velpeau bandage for 3 weeks. One year after surgery, external rotation of the shoulder was 45°, but she, too, had neither disabilities nor anxieties.