Seminario luxacion inveterada
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Transcript of Seminario luxacion inveterada
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Manejo de luxaciones inveteradas hombro
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Definicion
• Mas aceptado es mayor a 3 semanas• Incidencia 2 a 5 % de todas las luxaciones de
hombro
• Fisiologia del cartilago• Partesblans• Neurovascular
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Lucxaciones posteriores
• Pueden pasar inadvertidas en 60 % de los casos.
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Tratamiento
• Dado por tipo paciente• Tiempo de evolucion.• Lesiones asociadas• Daño condral
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Artroplastia
• 32 hombros 1878 al 2008 con luxacion posterior cronia• 14 con reversa• Daño cabeza 45%
• Jbjs 2014 vol96 num 3
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Aloinjerto osteocondra
• Clasica tecnica de mC laughlin modificado• Para defecto menores al 50%
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• Long-term outcome of segmental reconstruction of the humeral head for the treatment of locked posterior dislocation of the shoulder
• Christian Gerber, MD, FRCSEd(Hon)*, Sabrina Catanzaro, RN, Michele Jundt-Ecker, MD, Mazda Farshad, MD, MPH
• Department of Orthopaedics, University of Z€urich, Balgrist University Hospital, Z€urich, Switzerland
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• Objetivo:• Seguimiento de pacientes tratados con
aloinjerto tanto de cabeza humeral como femoral.
• Tratar mantener anatomia • Evitar tranferencia clasica de tuberosidad
menor
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• N= 21 pacientes• 1 bilateral• Rango de de fecto cabeza humeral 30 a 55%• Media de 43%• 4 mujeres 17 hombres• Causas: hipoglicemia, convulsiones, deportes• Rx simples y ct en todos los casos
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Resultados
• Seguimiento 10 .8 años• Constant _murleyscore• SSV
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• SSV mejoro de 33%( 0a 50 %) a 88% rango de 60 a 100%
• CS preop 37 puntos• CS post op 77 puntos• Dolor ( de 8 a 14 puntos donde 15 es ausencia
de dolor• Diferencias en agudos y subagudos vs los
cronicos.
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Reporte de Caso
• Paciente con luxacion posterior hombro• Hombre 54 años• 30% superficie articular• Maclaughlin modificado mas fijacion
subescapular con anclas
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The American Journal of Sports Medicine, Vol. 36, No. 1 DOI: 10.1177/0363546507311594
© 2008 American Orthopaedic Society for Sports Medicine
Open Reduction and Posterior Capsular Shift for Cases of Neglected Unreduced Posterior Shoulder Dislocation Mohamed Taha El Shewy,* MD, Hassan Magdy El Barbary, MD, Yasser Hassan El Meligy, MD, and Sherif Ahmed Khaled, MD From the Orthopedic Department, Cairo University, Cairo, Egypt
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• Serie de casos• Evidencia tipo 4• 17 pacientes con luxacion posterior
inveterada.• Impactacion de cabeza humeral menor de
25%
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• Se realizó reparacion capsular posterior en cruz según descripcion de Neer.
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