PDF(Pubmed)
Abstract：
BACKGROUND: The shoulder joint is one of the most freely movable joints in the human body and has therefore high importance for upper limb functionality. Several techniques have been developed to replace the glenohumeral joint including humeral hemiarthroplasty, anatomical total shoulder arthroplasty, and reverse total shoulder arthroplasty, depending on the underlying pathology. For the soft tissue reconstruction, the innervated latissimus dorsi musculocutaneous flap is a reliable solution flap in shoulder and arm reconstruction.
METHODS: We present the case of a 16-year-old male patient with a complete destruction of the shoulder joint and soft tissues after ballistic trauma. We performed the reconstruction of the shoulder joint using a humeral hemiarthroplasty with a mesh fixation to the remaining glenoid. The soft tissue coverage and the restoration of the deltoid muscle function were insured with a pedicled innervated latissimus dorsi musculocutaneous flap. One year postoperatively, the patient showed a good function of the shoulder joint with an excellent aesthetical result and no pain.
CONCLUSIONS: The pedicled latissimus dorsi musculocutaneous flap can safely restore the shoulder function, while the humeral hemiarthroplasty with mesh fixation can be a reliable solution for the reconstruction of a completely destructed shoulder joint.
METHODS: We present the case of a 16-year-old male patient with a complete destruction of the shoulder joint and soft tissues after ballistic trauma. We performed the reconstruction of the shoulder joint using a humeral hemiarthroplasty with a mesh fixation to the remaining glenoid. The soft tissue coverage and the restoration of the deltoid muscle function were insured with a pedicled innervated latissimus dorsi musculocutaneous flap. One year postoperatively, the patient showed a good function of the shoulder joint with an excellent aesthetical result and no pain.
CONCLUSIONS: The pedicled latissimus dorsi musculocutaneous flap can safely restore the shoulder function, while the humeral hemiarthroplasty with mesh fixation can be a reliable solution for the reconstruction of a completely destructed shoulder joint.
摘要：
背景：肩关节是人体中最自由活动的关节之一，因此对上肢功能非常重要。已经开发了几种技术来替代肱骨关节，包括肱骨半关节成形术。解剖全肩关节置换术，和反向全肩关节置换术，取决于潜在的病理学。对于软组织重建，神经支配背阔肌皮瓣是肩臂重建的可靠解决方案皮瓣。
方法：我们介绍了一名16岁男性患者，在弹道创伤后肩关节和软组织完全破坏的情况。我们使用肱骨半关节成形术对肩关节进行了重建，并将网状物固定在剩余的关节盂上。用带蒂神经支配的背阔肌肌皮瓣确保软组织覆盖和三角肌功能的恢复。术后一年,患者肩关节功能良好，美学效果良好，无疼痛。
结论：带蒂背阔肌肌皮瓣可以安全地恢复肩关节功能，而带网状固定的肱骨半关节成形术可以是重建完全破坏的肩关节的可靠解决方案。
方法：我们介绍了一名16岁男性患者，在弹道创伤后肩关节和软组织完全破坏的情况。我们使用肱骨半关节成形术对肩关节进行了重建，并将网状物固定在剩余的关节盂上。用带蒂神经支配的背阔肌肌皮瓣确保软组织覆盖和三角肌功能的恢复。术后一年,患者肩关节功能良好，美学效果良好，无疼痛。
结论：带蒂背阔肌肌皮瓣可以安全地恢复肩关节功能，而带网状固定的肱骨半关节成形术可以是重建完全破坏的肩关节的可靠解决方案。
