黄刚-深圳市龙岗骨科医院(0001).pdf

CASE DISCUSSIONHuang Gang The Affiliated Orthopaedic Hospital of Shenzhen UniversityChongqing2018Case1 Personal Data:49 Y,Male,Right hand dominant Chief Complaint:A 6-week history of right shoulder pain and reduced function caused by a fall Past History:Nothing Surgery history:NothingHistory ROM(Active/Passive):Fexion45/45,ER 50/50 Video or Pictures Special Physical Examination:Obrien+,Job+Others:ASES:22/100,Constant-Murley:37/100,ROWE:40/100PhysicalExaminationPre-operative Images(X ray/CT/MRI)Diagnosis OptionsPlease choose the diagnosis you preferred:1.Traumatic dislocation of shoulder joint2.Bony bankart lesion3.Hill-Sachs lesion4.Rotator Cuff TearsPlease vote within 10 secondsMy diagnosis and why1.Chronic locked anterior shoulder dislocation2.Rotator Cuff Tears 1.typical medical history,3 weeks 2.physical examination 3.X-ray,CT,MRIPlease choose the treatment you preferred:1.Conservative treatment2.open reduction3.bankart repair4.Remplissage procedure5.Rotator cuff repair6.Latarjet procedure(open or arthroscopic)7.hemiarthroplasty/Shoulder arthroplastyPlease vote within 10 secondsTreatment OptionsMy treatment and why1.Arthroscopic Latarjet procedure(endobutton)2.Remplissage procedure3.Rotator cuff repairResult and Post-operative Images(X ray/CT/MRI)Post-operative 1w Post-operative 4w Post-operative 8w Supporting Evidence(Paper reviews)The Latarjet procedure for the treatment of chronic locked anterior shoulder dislocation can be successful if the shoulder reduction can be performed without requiring a subscapularis tenotomy.If this reduction is not possible,then other surgical reconstruction should be considered.A guided surgical approach optimizes graft positioning accuracy.Suture button fixation can be an alternative to screw fixation,obtaining an excellent rate of bone union.Neurologic and hardware complications,classically reported with screw fixation,have not been observed with this guided technique and novel fixation method.Discussion