Arthroscopically Assisted Reduction in a Chronic Locked Posterior Shoulder Dislocation

Abstract

Neglected posterior shoulder dislocation is a difficult condition in terms of decision making and surgical technique. Not only the bony deformity but also the soft tissue and patient's underlying disease are of concern. Whether the poor results are associated with a time delay or the treatment method is not clear yet. To date, there is neither a consensus nor treatment guidelines. We describe an arthroscopically assisted reduction and open McLaughlin procedure. The advantage of this procedure is preservation of the soft tissue of the anterior part of the shoulder during the surgical reduction technique for chronic neglected posterior shoulder dislocation cases.

Arthroscopic Reduction of a Chronic Locked Posterior Shoulder Dislocation

“…However, we believe that their case was not a typical chronically locked case because in a typical case, the locked humeral head prevents glenohumeral access through the routine posterior portal and the only window by which to reach the glenohumeral joint is through the rotator interval. Prasathaporn et al 5 reported an arthroscopy-assisted reduction case. In their case, the arthroscopic technique was used just for debridement outside the rotator interval, whereas open procedures were used to access the glenohumeral joint and perform reduction.…”

“…Prasathaporn et al. 5 reported an arthroscopy-assisted reduction case. In their case, the arthroscopic technique was used just for debridement outside the rotator interval, whereas open procedures were used to access the glenohumeral joint and perform reduction.…”

“…However, for a chronic posterior shoulder dislocation, which usually appears in a locked status, a medial-to-lateral reduction and anterior-to-posterior soft-tissue balance are difficult to realize. 5 , 6 We consider the capsule-muscle contracture and adhesion to be the main mechanisms that impede the lateralization of the humeral head and consider the rotator interval contracture, scar formation around the subscapularis, and obstruction of the biceps to be the main mechanisms of anterior-posterior imbalance. Thus, we have developed a special arthroscopic shoulder release and reduction technique to address all these pathologic changes.…”

Manejo y tratamiento no quirúrgico de la luxación de hombro

“…El manejo inicial es funcional en la mayoría de los casos con un 80% de éxito en casos de hiperlaxitud o en ausencia de anormalidad del hueso. (11). Aproximadamente el 50% de estas luxaciones están asociadas con lesiones de Hill-Sachs inversas, que es una fractura por impactación de la cara anteromedial de la cabeza humeral, puede pasarse por alto en hasta el 60% de los casos (12).…”

All-Arthroscopic Management of Locked Posterior Shoulder Dislocation: Reduction Under Direct Visualization and Treatment of Intra-articular Pathologies

“…This can decrease the presence of fibrous tissue and lower the risk of iatrogenic fractures during reduction maneuvers. 7 , 8 , 9 , 10 …”