[Fracture dislocations of the shoulder].
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Report of an unusual case, that of a 60-year-old man who experienced concomitant bilateral anterior shoulder dislocations with associated bilateral brachial plexus and axillary artery injury. The report also highlights some of the bony and neurovascular lesions associated with shoulder dislocation.
We analysed retrospectively 50 humerus fractures in the vicinity of elbow joint and 40 fractures of the proximal humerus with respect to possible injuries of the vessel pattern of the epiphyseal plate. The normal vessel pattern of the epiphyseal plate was examined postmortem on 8 foetus and newborns up to 6 months. We plastinated the affected regions and could compare symmetry of the vessel pattern in the epiphyseal plates as well as therapeutic consequences, especially after injuries of the elbow joint. Vascular disturbances in the case of young children, i.e. by fractures of the lateral oder medial condyle are undoubtedly seen. A fish-tail deformity can be a complication. By older children with mature epiphyseal plate we could not register any complications. In such cases we are interested in restoring the joint stability by refixation.
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A 48-year-old patient sustained depressed fracture dislocations of both shoulder joints during a grand mal epileptic seizure. Surgical treatment consisting of implantation of two Neer total replacements was successful: the functional result was good, and within 12 weeks the patient was free of pain and able to resume work.
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Results after conservative or surgical treatment of comminuted fractures of the head of the humerus are often unsatisfactory and complicated by pain and a severely decreased range of motion. In these patients good results have been obtained by replacement of the humeral head with the Isoelastic Humeral Head Prosthesis. Fourteen cases are reported and their results discussed.
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