No abstract

Posterior dislocation of the shoulder is an unfrequent event that often occurs as a consequence of a direct trauma or epileptic crisis. Frequently the posterior dislocations are misunderstood, so they become chronic lesions. We reported a case of an acute posterior left shoulder dislocation with lesser tuberosity fracture and reverse Hill-Sachs lesions which involved more than 25% of the articular surface of the humeral head, in a 57-old-year man with right hemiparesis. We performed a synthesis of the lesser tuberosity with a screw, and we restored the shape of the humeral head with allograft. We achieved a good result that allows the patient to be able to do his previous activities of daily living.

Ipsilateral obturator hip dislocation and femoral shaft fracture are rare. We report such a case in an older woman after a low-energy injury. She had a knee prostheses in the same limb. The patient was treated by open manipulative reduction of the luxation without opening joint and open reduction and internal fixation of the femur with angular stability plate and screws. We could not find a similar case in the literature. An early diagnosis of the dislocation is crucial in order to obtain good results. Great awareness and radiologic examination are fundamental to achieve precocious diagnosis of both these rare combined injuries, as treatment in these cases is considered an emergency. The first step was an attempt to reduce the dislocation by closed means but it failed. Then we performed a short approach at the trochanteric region and used Lambotte forceps to manoeuvre the proximal femur without opening the joint achieving reduction. Thereafter the femoral shaft fracture underwent open reduction and internal fixation with an angular stable plate. After a 2-year follow-up the outcome was very good.