KRONİK KİLİTLİ ÖNE OMUZ ÇIKIĞI İÇİN KOMBİNE CERRAHİ: LİTERATÜR DERLEMESİ VE OLGU SUNUMU

Abstract

Omuz çıkıkları sıklıkla eğer 3 haftadan daha eski ise kronik olarak adlandırılmaktadırlar. Bu çıkıkların çoğuna büyük Hill-Sachs lezyonları, glenoid kavite kemik kayıpları ve nörolojik yaralanmalar eşlik edebilir. Bizim olgumuz 66 yaşında bir bayan ve düşme sonucu başvurduğu merkezde sadece Radius alt uç kırığı olarak tedavi edilmiş, öne omuz çıkığı atlanmış. Kronik kilitli öne omuz çıkığının sonucu olarak büyük bir Hill-Sachs lezyonu olduğu saptandı. Yaralanmadan yetmiş gün sonra hastanın omuz rahatsızlığından (ağrı ve hareket kısıtlılığı) dolayı hastaya tedavi olarak; açık redüksiyon, Latarjet Prosedürü ve proksimal humeral içe döndürme osteotomisi uygulandı. Bu tedavi kombinasyonu kronik omuz çıkığı için İngilizce literatürde bir ilktir. Bir yıl sonra hasta ameliyat sonucundan oldukça memnun kalmıştır. Hasta fonksiyonel omuz hareketini kazanmış ve omzunun instabilite olmadan ağrısız olduğu saptanmıştır. Büyük Hill-Sachs lezyonları yaşlı hastalarda genel olarak hemiartroplasti ile tedavi edilmektedir ancak hastanın kendi kemiği korunarak da başarılı sonuç alınabilir.

Keywords

• Omuz çıkığı,kronik

A COMBINED SURGERY FOR CHORONIC LOCKED ANTERIOR SHOULDER DISLOCATION: CASE REPORT AND REVIEW OF THE LITERATURE

Abstract

Shoulder dislocations are commonly named chronic if it is older than 3 weeks. Many of these dislocations can be complicated by large Hill-Sachs lesions, glenoid cavity bone loss and neurologic injuries. Our case is 66 years old female and she had been treated only as distal radius fracture by a center and anterior shoulder dislocation was missed. As a result of chronic locked anterior locked dislocation, she had a large Hill-Sach lesion. Seventy days after injury; because of the patient’s shoulder discomfort (pain and limited motion) we performed open reduction, Latarjet Procedure and proximal humeral internally rotating osteotomy as a treatment. This type of treatment for chronic anterior dislocation is used firstly by us in English literature. After one year the patient was satisfied with the result. She gained functional motion and she was pain free without shoulder instability. Large Hill-Sach lesions are commonly treated by hemiarthroplasty if the patient is elderly. But preserving patients own bone can be successful too.

Keywords

• Shoulder dislocation,chronic

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