Surgical treatment of subchondral osteonecrosis of the humeral head: A case report and literature review

• Published in: Medicine (Baltimore) 2023-08, Vol.102 (31), p.e34389-e34389
• Main Authors: Liu, Yongsheng, Zhong, Jia, Jiang, Zhaowei, Shen, Duo, Zhao, Daohong
• Format: Article
• Language: English
• Subjects: Adolescent; Clinical Case Report; Humans; Humeral Head - diagnostic imaging; Humeral Head - pathology; Humeral Head - surgery; Male; Necrosis - pathology; Osteonecrosis - diagnostic imaging; Osteonecrosis - etiology; Osteonecrosis - surgery; Range of Motion, Articular; Shoulder - surgery; Shoulder Joint - diagnostic imaging; Shoulder Joint - pathology; Shoulder Joint - surgery; Treatment Outcome
• ISSN: 0025-7974; 1536-5964
• DOI: 10.1097/MD.0000000000034389

Osteonecrosis of the humeral head is an uncommon subchondral bone disease with many etiologies, and there is currently no definite evidence to support an optimal surgical treatment plan. We report a case of surgical treatment of left humeral head necrosis. To the best of our knowledge, this is the youngest patient with non-drug-induced humeral head necrosis and the largest collapsed area. The case involved a 16-year-old male who injured his left shoulder 1 year ago. The patient was admitted to the hospital because of shoulder pain after activity in the year following the injury. During the physical examination, the left glenohumeral joint space was tender, the pain was obvious when the shoulder joint was rotated and squeezed, and the active and passive range of motion was normal. X-ray, magnetic resonance imaging, and computed tomography + 3D computed tomography scans all showed subchondral osteonecrosis of the left humeral head. Left humeral head lesion removal and autologous osteochondral transplantation were performed, and the patient was followed up. Non-drug-induced humeral head necrosis is rare. Autologous osteochondral transplantation is currently one of the most mature and effective treatment methods. The short-term curative effect in this patient is satisfactory, but the patient is young and has a large collapsed area, so long-term follow-up is worthwhile.