Arthroscopic Treatment of Acute Traumatic Anterior Glenohumeral Dislocation and Greater Tuberosity Fracture
CASE REPORT A 46-year-old right-hand dominant man was involved in a polo accident and sustained an anteriorinferior glenohumeral dislocation along with a greater tuberosity fracture (Fig 1). The dislocation was reduced in the emergency room but, because of the displacement of the greater tuberosity fracture, the treating orthopaedist referred the patient to our office. His medical history included no prior significant shoulder problems. Physical examination was limited by pain from the shoulder injury but it revealed normal neurovascular status. Plain radiographs showed prereduction and postreduction views of the dislocation and displaced greater tuberosity fracture (Fig 2). The patient wished to pursue his avocation of competitive polo, so we advised operative treatment. SURGICAL TECHNIQUE After the successful induction of general anesthesia with interscalene block supplementation, we placed the patient in the sitting position and prepared and draped the arm. An incision was made 1 cm inferior and 1 cm medial to the posterolateral corner of the acromion and the blunt trocar and cannula were inserted into the glenohumeral joint. A Bankart lesion was seen with detachment of the labrum-ligament complex from 1 to 4 o'clock. The anterior scapular neck and glenoid rim were abraded and two suture anchors inserted. The labrum-ligament complex was reattached anatomically. The arthroscope was removed and attention turned to the subacromial space. The trocar and cannula were inserted into the subacromial space and the lateral portal site was identified with a spinal needle. A large self-sealing cannula and trocar were inserted, followed by an arthroscopic probe. The... (download full pdf article)
•
del.icio.us
digg
facebook
Acute traumatic anterior glenohumeral 1999.pdf 95.577 KB (95577 bytes)
