2000 年 49 巻 4 号 p. 1200-1204
Posterior fracture-dislocations (PFD) of the shoulder are rare, accounting for approximately 1 to 4% of all shoulder injuries. We reported 5 cases of posterior fracture-dislocation of the shoulder. One case was only posterior dislocation and the other 4 cases were 2-part PFD. Four out of 5 cases were misdiagnosed at the first examination. It took an average of 4 weeks for correct diagnoses of these 4 cases. Closed manipulation and percutaneous pinning were performed on only one fresh case. Open reduction and/or osteosynthesis were performed on the remaining 4 cases. The average range of motion was 156 degrees in flexion, and 60 degrees in external rotation. In internal rotation, average 3.6 vertebral body was restricted compared to the healthy side. Although the over all results were acceptable, 4 cases in which dislocation was over-looked complained of misdiagnosis of initial medical check.
Posterior dislocation of the shoulder is difficult to detect with only the anteroposterior view of plain X-ray. An awxillary radiograph or CT is essential for the diagnosis of posterior fracture-dislocations.