Congenital shoulder joint dislocation

　　Congenital shoulder joint dislocation is rare in clinical practice and is not caused by human factors. The exact etiology of the disease is not yet clear. Due to congenital absence of bone or surrounding soft tissue, shoulder joint anterior, posterior, and inferior dislocations can occur.

　　As this is a congenital disease, the dislocation is a result formed in the womb, and there are no other reported complications. However, it can cause functional impairment and skeletal deformities in the child, such asCombined with skeletal deformities of the upper limb. . Once diagnosed, active treatment is required.

　　The shape and degree of limitation of the shoulder joint function vary with the severity of the deformity. Poor development or absence of the glenoid or humeral head can exacerbate the deformity, and increased instability of the shoulder joint often results in skeletal deformities of the upper limb.

　　1. Active and passive movements of the shoulder joint are limited.

　　2. The deltoid muscle of the shoulder collapses, presenting a square shoulder deformity. The dislocated humeral head can be felt under the axilla, coracoid process, or clavicle, and the glenoid cavity is empty.

　　This disease is a congenital condition with no effective preventive measures. Early diagnosis and treatment are the key to preventing and treating the disease. At the same time, attention should be paid to reducing violent actions such as pulling and dragging during the production process to avoid injury to the baby.

　　Congenital shoulder joint dislocation requires shoulder joint abduction test, scapula examination, bone and joint and soft tissue CT examination, vertebral plain film, and general radiography examination. X-ray examination has the following two positions:

　　1. Shoulder Joint Anteroposterior Position

　　(1) The humeral head is in an internal rotation deformity, and the shadow of the greater tubercle is not visible.

　　(2) The superimposed shadow of the humeral head and the glenoid decreases or disappears, and the glenoid can be completely exposed. In the normal X-ray anteroposterior film of the shoulder joint, the humeral head and the posterior three-quarters of the glenoid form a superimposed semicircular shadow, and the image of the articular surface of the humeral head and the glenoid anterior margin is smooth arcuate curve. However, this parallel relationship is destroyed in the case of posterior shoulder joint dislocation.

　　(3) The distance between the articular surface of the humeral head and the anterior and inferior margins of the glenoid increases by more than 6mm.

　　Because the humeral head does not move downward when it is posteriorly dislocated, the anteroposterior film shows that the joint alignment is still good, and the joint gap still exists, so it is easy to miss the diagnosis.

　　2. Axillary Shoulder Joint Position

　　In the anteroposterior shoulder joint film, if there is a suspicion of posterior shoulder joint dislocation, it is best to take an axillary position film. The axillary position film can clearly show the interposition relationship between the humeral head and the glenoid, whether the humeral head is displaced, and can show the possible combined lesions of the glenoid and the humeral head. Therefore, the axillary position projection has the significance of confirming the diagnosis.

　　The diet of patients with congenital shoulder dislocation should be light, easy to digest, with more fruits and vegetables, a reasonable diet, and attention to adequate nutrition. In addition, patients should also pay attention to avoiding spicy, greasy, and cold foods.

　　For patients with mild shoulder joint dysfunction, surgical treatment is not necessary, as it may further impair the function after surgery. Manual reduction can be performed, but it is easy to have shoulder joint redislocation after treatment.

　　For the surgical treatment of severe patients, the choice of shoulder joint capsular reduction technique, tendon transfer, shoulder joint functional position fusion, and excision of acromial deformity bone block depends on different conditions. However, these operations may limit the activity of the shoulder joint. For patients with severe shoulder joint dysplasia, surgery is usually ineffective and cannot improve their function.