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Z Orthop Unfall 2024; 162(01): 85-91
DOI: 10.1055/a-1881-4796
Case Report

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
Manuela Nötzli
1   Shoulder and Elbow Surgery, Schulthess Klinik, Zurich, Switzerland (Ringgold ID: RIN30699)
,
Yacine Ameziane 
1   Shoulder and Elbow Surgery, Schulthess Klinik, Zurich, Switzerland (Ringgold ID: RIN30699)
,
Markus Scheibel
1   Shoulder and Elbow Surgery, Schulthess Klinik, Zurich, Switzerland (Ringgold ID: RIN30699)
2   Shoulder and Elbow Surgery, Center for Musculoskeletal Surgery, Charité Universitätsmedizin Berlin, Berlin, Germany (Ringgold ID: RIN14903)
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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.

Keywords

osteochondral shear injury - bioabsorbable fixation - humeral fracture

Schlüsselwörter

Scherfraktur - bioresorbierbare Implantate - Humerusfraktur


Publication History

Received: 09 February 2022

Accepted after revision: 08 June 2022

Article published online:
23 May 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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