Pustaka Ilmiah Universitas Padjadjaran

Abstrak

Ulnar Claw-Hand Related Neglected Post-Traumatic Anterior Shoulder Joint Dislocation

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. Numb-ness 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.