A treatment algorithm for locked posterior dislocation of shoulder

Babhulkar, Ashish; Unnithan, VB; Patil, Prateek

doi:10.1016/j.jajs.2018.05.011

Cited by 5 publications

(8 citation statements)

References 15 publications

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“…The clinical results obtained with the original or modified McLaughlin procedures in patients with locked posterior shoulder dislocation were favourable and comparable with those of other published studies [ 7 , 17 , 18 , 35 ].…”

Section: Discussionsupporting

confidence: 86%

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Treatment and outcomes of chronic locked posterior shoulder dislocations: a retrospective case series

Haritinian

Stoica

Popescu

et al. 2023

BMC Musculoskelet Disord

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Background Posterior shoulder dislocations are rare injuries that are often missed on initial presentation. Cases left untreated for more than three weeks are considered chronic, cannot be reduced closely (they become locked) and are usually associated with a significant reverse Hill-Sachs defect. The aim of this study was to evaluate the outcomes of chronic locked posterior shoulder dislocations treated with the McLaughlin procedure (classic or modified). Methods This retrospective study included 12 patients with chronic locked posterior shoulder dislocation operated on between 2000 and 2021 by two surgeons in two institutions. Patients received a thorough clinical examination and radiological assessment before and after surgery. Shoulders were repaired with the McLaughlin or modified McLaughlin procedure. Outcomes were assessed by comparing pre- and postoperative values of clinical variables. Results Most of the dislocations were of traumatic origin. The average delay between dislocation and surgical reduction was 13.5 ± 9.7 weeks. Postoperative clinical outcomes were favourable, with an average subjective shoulder value of 86.4 ± 11.1 and a normalized Constant –Murley score of 90 ± 8.3. None of the patients had a recurrence of shoulder dislocation, but one patient developed avascular necrosis of the humeral head and two patients developed glenohumeral osteoarthritis. Conclusions In this group of patients with chronic locked posterior shoulder dislocation, the clinical outcomes of McLaughlin and modified McLaughlin procedures were satisfactory, even when surgery was significantly delayed.

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Section: Discussionsupporting

confidence: 86%

“…True anteroposterior and axillary or scapular Y radiographic views of the affected shoulder are also required. Several diagnostic signs (light bulb, vacant glenoid, double trough, rim) have been described on anteroposterior radiographs [ 5 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Treatment and outcomes of chronic locked posterior shoulder dislocations: a retrospective case series

Haritinian

Stoica

Popescu

et al. 2023

BMC Musculoskelet Disord

View full text Add to dashboard Cite

show abstract

“…The clinical results obtained with the original or modi ed McLaughlin procedures in patients with locked posterior shoulder dislocation were favourable and comparable with those of other published studies [7,17,18,33].…”

Section: Discussionsupporting

confidence: 85%

“…Proximal humerus derotational osteotomy [21,22,37] can also lead to good outcomes in patients without severe articular cartilage damage. However, because of the technical complexity of the procedure and the risk of humeral head necrosis and osteoarthritis progression, some surgeons only consider derotational osteotomy as a salvage procedure when there are no other treatment options [7].…”

Section: Discussionmentioning

confidence: 99%

Treatment and outcomes of chronic locked posterior shoulder dislocations: A retrospective case series

Haritinian

Stoica

Popescu

et al. 2022

Preprint

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Background Posterior shoulder dislocations are rare injuries that are often missed on initial presentation. Cases left untreated for more than three weeks are considered chronic, cannot be reduced closely (they become locked) and are usually associated with a significant Hill-Sachs defect. The aim of this study was to evaluate the outcomes of chronic locked posterior shoulder dislocations treated with the McLaughlin procedure (classic or modified). Methods This retrospective study included 12 patients with chronic locked posterior shoulder dislocation operated on between 2000 and 2021 by two surgeons in two institutions. Patients received a thorough clinical examination and radiological assessment before and after surgery. Shoulders were repaired with the McLaughlin or modified McLaughlin procedure. Outcomes were assessed by comparing pre- and postoperative values of clinical variables. Results Most of the dislocations were of traumatic origin. The average delay between dislocation and surgical reduction was 13.5 ± 9.7 weeks. Postoperative clinical outcomes were favourable, with an average subjective shoulder value of 86.4 ± 11.1 and a normalized Constant –Murley score of 90 ± 8.3. None of the patients had a recurrence of shoulder dislocation, but one patient developed avascular necrosis of the humeral head and two patients developed glenohumeral osteoarthritis. Conclusions In this group of patients with chronic locked posterior shoulder dislocation, the clinical outcomes of McLaughlin and modified McLaughlin procedures were satisfactory, even when surgery was significantly delayed.

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“…In a recent systematic review, Basal O. et al [ 13 ] have pointed out that the McLaughlin arthroscopic technique should be preferred in the case of acute irreducible posterior dislocations (less than three weeks after injury) with low bone loss (less than 20%), even if the open surgery as described by Neer gives similar functional outcomes. In 2020, Georgios Paparoidamis et al [ 14 ] highlighted how the Neer’s modification leads to better functional results compared to arthroscopic treatment in cases of chronic posterior dislocations (more than three weeks after injury) with less than 40% bone loss.…”

Section: Discussionmentioning

confidence: 99%

Posterior Shoulder Dislocation with Engaging Reverse Hill–Sachs Lesion: A Retrospective Study of Ten Patients Treated with Arthroscopy or Open Reduction and Stabilization

Ippolito

Zitiello

Marinis

et al. 2021

JCM

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This study compares two surgical techniques used to treat patients with posterior shoulder dislocation with an engaging reverse Hill–Sachs lesion. We assessed ten patients who were treated at the Surgical Orthopedic and Traumatological Institute (ICOT) of Latina and the Clinic of Orthopedic and Traumatological Surgery of the ASST Sette Laghi of Varese between 2016 and 2019. The patients were divided into two groups: the first comprising six patients who underwent the open surgery McLaughlin procedure as modified by Neer, the second including four patients who underwent the arthroscopic McLaughlin procedure. All patients received postoperative rehabilitation to achieve the best possible functional recovery of the affected shoulder. We then assessed the shoulder range of motion, the pain level, and the impact on quality of life with four tests: the Constant Scale, the Simple Shoulder Test (SST), the OXFORD Scale, and The University of California—Los Angeles (UCLA) Shoulder Scale. The mean scores of the first group were: 81.3 ± 9.8 SD (Constant Scale), 10.8 ± 1.06 SD (SST), 42.5 ± 5.4 SD (Oxford Scale), 30.8 ± 3.02 SD (UCLA Shoulder Scale); we calculated the following mean scores in the second group: 80.25 ± 4.1 SD (Constant Scale), 11.5 ± 0.8 SD (SST), 42 ± 4.06 SD (Oxford Scale), 32 ± 2.9 SD (UCLA Shoulder Scale). We found no significant differences between the two groups.

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A treatment algorithm for locked posterior dislocation of shoulder

Cited by 5 publications

References 15 publications

Treatment and outcomes of chronic locked posterior shoulder dislocations: a retrospective case series

Treatment and outcomes of chronic locked posterior shoulder dislocations: a retrospective case series

Treatment and outcomes of chronic locked posterior shoulder dislocations: A retrospective case series

Posterior Shoulder Dislocation with Engaging Reverse Hill–Sachs Lesion: A Retrospective Study of Ten Patients Treated with Arthroscopy or Open Reduction and Stabilization

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