Management einer chronischen vorderen, verhakten Schulterluxation während des COVID-19-Lockdowns

ZusammenfassungIn diesem Beitrag wird der Fall einer chronisch verhakten vorderen Schulterluxation bei einem 25-jährigen, geistig retardierten Patienten geschildert, welcher während des ersten COVID-19-Lockdowns eine verspätete orthopädisch-fachärztliche Versorgung erhielt. Die Therapie bestand in der offenen Reposition mittels Tuberculum-minus-Osteotomie, einer Auffüllung des Hill-Sachs-Defekts sowie einer knöchernen Glenoidaugmentation, jeweils mit autologem trikortikalem Beckenkammspan. Die hierzulande seltene Verletzung zeigt in Ländern mit erschwertem Zugang zum Gesundheitssystem eine höhere Inzidenz mit hochgradiger Funktionseinschränkung.

Comparative characteristics of shoulder blade (Scapula) and shoulder bone (Humerus) of roe deer (Capreolus capreolus) and sheep (Ovis aries) in order to determine the animal species

In illegal hunting it is often possible only on the basis of morphological characteristics to determine the animal species. By the method of comparison there was performed the forensic analysis of roe deer and sheep osteological features. For the purpose of investigating the shoulder blade (Scapula) and shoulder bone (Humerus) comparative characteristics, there were used 6 shoulder blades and 6 shoulder bones of roe deer and 8 shoulder blades and 8 shoulder bones of sheep. After the skin, muscles, arterial, venous and lymphatic vessels as well as nerves were removed from the bones, they were thermally treated in an autoclave. Subsequently, the bones were placed in 3% solutioin of hydrogen peroxide (H2O2) for bleaching and degreasing. Then they were air dried and then photographed. Shoulder blade (Scapula) is a bone plate (Ossa plana) roughly triangular in shape. Scapular spine (Spina scapulae) is much more prominent in roe deer with acromion blade in the form of spike, while in sheep it is shorter and ends with acrimion at a right angle. Shoulder blade cup (Cavitas glenoidalis) in roe deer is round in shape, and in sheep it is oval. Tuberculum supraglenoidale and Processus coracoideus in sheep are more and in roe deer less developed. Shoulder bone (Humerus) in roe deer is relatively long, slender bone with proximal convexity turned cranially in regard to the same bone in sheep, which is stronger and heavier. Tuberculum majus in roe deer is less developed, and in sheep it is in a form of solid bone protuberance. Tuberculum minus and Tuberositas deltoidea in sheep are more developed than in roe deer. At medial condyle (Condylus medialis) in sheep there is shallow and wide groove, while in roe deer it is deeper and narrower. On the basis of morphological differences of roe deer and sheep bones, it can be determined with certainty which animal spesies they belong to.