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DOI: 10.1055/a-1881-4796
Missed Osteochondral Shear Injury of the Humeral Head Following Anterior Shoulder Dislocation - A Case Report
Die übersehene osteochondrale Scherfraktur des Humeruskopfes nach anteriorer Schulterluxation - ein Fallbericht
Abstract
Case Two months after anterior shoulder dislocation and spontaneous reduction, a 41-year-old man presented movement-related shoulder pain and a functional deficit. An initially missed osteochondral shearing injury of the humeral head with a Bankart lesion was diagnosed. Due to an extensive posteroinferior defect, an open reduction and internal fixation (ORIF) using bioabsorbable chondral darts was performed. At the 1-year follow-up, magnetic resonance images showed a completely healed osteochondral fragment and the patient presented an unrestricted shoulder function.
Conclusion Even in missed osteochondral shear injuries, ORIF with bioabsorbable implants can be associated with an excellent functional outcome and sufficient integrity of the fragment. The absorbable implants are biocompatible, therefore the risk of revision surgery due to implant irritations is minimized.
Zusammenfassung
Zwei Monate nach einer traumatischen vorderen Schulterluxation stellte sich ein 41 jähriger Patient mit persistierenden bewegungsabhängigen Schulterschmerzen sowie einer eingeschränkten Beweglichkeit vor. Eine initial übersehene postero-inferiore osteochondrale Scherfraktur des Humeruskopfes wurde diagnostiziert und mittels offener Reposition und interner Fixierung (ORIF) durch bioresorbierbare chondrale Darts versorgt. Nach einem Jahr zeigte sich radiologisch eine vollständige Integrität des Fragments im Knochen sowie ein uneingeschränktes funktionelles Outcome des Patienten.
Dieser Fall zeigt, dass sogar initial übersehene Scherfrakturen des Humeruskopfes nach ORIF mittels bioresorbierbarer Implantate zu einem exzellenten Outcome führen können. Durch die biologische Art der Refixation könnten weiterhin implantatassoziierte Komplikationen verhindert und somit Revisionsoperationen zur Implantatentfernung potentiell verhindert werden.
Publication History
Received: 09 February 2022
Accepted after revision: 08 June 2022
Article published online:
23 May 2023
© 2023. Thieme. All rights reserved.
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References
- 1 Hill HA, Sachs MD. The Grooved Defect of the Humeral Head: A Frequently Unrecognized Complication of Dislocations of the Shoulder Joint. Radiology 1940; 35: 690-700
- 2 Rowe CR, Zarins B, Ciullo JV. Recurrent anterior dislocation of the shoulder after surgical repair. Apparent causes of failure and treatment. J Bone Joint Surg Am 1984; 66: 159-168 (PMID: 6693441)
- 3 Campbell M, Fan B, Galdi B. Shearing Osteochondral Fracture of the Humeral Head: A Case Report. JBJS Case Connect 2019; 9: e0094 DOI: 10.2106/jbjs.cc.18.00094. (PMID: 31259748)
- 4 Fandridis E, Stavropoulos S, Dimo L. et al. Osteochondral humeral head fracture after posterior shoulder subluxation: A case report. Int J Shoulder Surg 2014; 8: 55-57 DOI: 10.4103/0973-6042.137529.
- 5 Bauer KL. Osteochondral Injuries of the Knee in Pediatric Patients. J Knee Surg 2018; 31: 382-391 DOI: 10.1055/s-0038-1625956. (PMID: 29381884)
- 6 Chen JW, Rosinsky PJ, Shapira J. et al. Osteochondral Allograft Implantation Using the Smith-Peterson (Anterior) Approach for Chondral Lesions of the Femoral Head. Arthrosc Tech 2020; 9: e239-e245 DOI: 10.1016/j.eats.2019.10.003. (PMID: 32099778)
- 7 Choi YS, Potter HG, Scher DM. A shearing osteochondral fracture of the humeral head following an anterior shoulder dislocation in a child. HSS J 2005; 1: 100-102 DOI: 10.1007/s11420-005-0117-z. (PMID: 18751816)
- 8 Quinzi DA, Lipof J, Gorczyca JT. Osteochondral Fracture-Dislocation of the Humeral Head in Adolescent Patient: Open Reduction and Internal Fixation with Low Profile Compression Screws. Am J Surg Tech Case Rep 2020; 1: 1008
- 9 Chotel F, Knorr G, Simian E. et al. Knee osteochondral fractures in skeletally immature patients: French multicenter study. Orthop Traumatol Surg Res 2011; 97: S154-S159 DOI: 10.1016/j.otsr.2011.09.003. (PMID: 22041573)
- 10 Schlechter JA, Nguyen SV, Fletcher KL. Utility of Bioabsorbable Fixation of Osteochondral Lesions in the Adolescent Knee: Outcomes Analysis With Minimum 2-Year Follow-up. Orthop J Sports Med 2019; 7: 2325967119876896 DOI: 10.1177/2325967119876896. (PMID: 31696131)
- 11 Morris JK, Weber AE, Morris MS. Adolescent Femoral Chondral Fragment Fixation With Poly-L-Lactic Acid Chondral Darts. Orthopedics 2016; 39: e362-e366 DOI: 10.3928/01477447-20160129-05. (PMID: 26840696)
- 12 Spross C, Farei-Campagna JM, Gerhard P. et al. Osteochondral Shearing Fracture of the Humeral Head Associated with Traumatic Anterior Shoulder Dislocation: A Case Report. JBJS Case Connect 2021; 11: 1-5 DOI: 10.2106/jbjs.cc.20.00938. (PMID: 34264877)