TITLE:
Ulnar Claw-Hand Related Neglected Post-Traumatic Anterior Shoulder Joint Dislocation
AUTHORS:
Hermawan Nagar Rasyid
KEYWORDS:
Anterior Shoulder Dislocation, Neglected, Ulnar Claw-Hand
JOURNAL NAME:
Open Access Library Journal,
Vol.4 No.3,
March
20,
2017
ABSTRACT: Shoulder joint is the most frequently dislocated
joint. Humeral head dislocation pushed the nerve toward medial side. Neglected
shoulder dislocation is difficult to manage and requires extensive procedures to obtain good functional outcome.
In the case of negligence, it is often found loss of the anterior capsule due
to absorption of the capsule. Nerve lesions, in particular the ulnar nerve, often do not receive
attention. Clinically, it often occurred from neurapraxia to severe condition
like claw-hand deformity. In my experience of a neglected case, there was a
53-year-old woman who presented to the orthopaedic clinic with a left anterior
shoulder fracture dislocation following a fall onto the right shoulder and
upper right arm. She had treated herself at home for around six months before
visiting the clinic. She also complained of some deformities on her ring and
little fingers, known as ulnar claw-hand. Numbness and tingling on her left hand especially on the ring and little fingers were observed. These findings were carefully documented and the patient
was aware of these persistent abnormalities. She had electromyography (EMG) and nerve conduction velosity (NCV) examination evidence of persistent ulnar nerve deficit, performed before and after
surgery. We may conclude that this case highlights the need for awareness of
the potential for nerve damage following shoulder dislocation. After treating
the dislocation, the functional and EMG results are very satisfactory.