Chronic locked posterior shoulder dislocation with severe head involvement

Abstract

Arthroplasty is the treatment of choice for severely damaged humeral heads in chronic locked posterior dislocation of the shoulder. We retrospectively reviewed the results of 12 shoulder arthroplasties (11 patients) between 1999 and 2005. Mean follow-up was 37.4±16.8 months. Mean postoperative Constant score (CS) was 59.4±21.6 (normative age and gender-related CS 67.1±24). There was a significant improvement in range of motion for flexion, abduction and external rotation. There was negative correlation (Pearson's coefficient) between the related CS and number of previous operations, pain and duration of symptoms. One patient underwent revision surgery 36 months postoperatively with polyethylene insert exchange. There were two patients with mild and one with severe migration of the humeral head. Shoulder arthroplasty resulted in good midterm results for this patient group with benefits for range of motion, pain and patient satisfaction.

Total shoulder arthroplasty in dislocation arthropathy

“…Posterior instability appears solely to correlate to a higher degree of instability induced arthritis [10,11]. Using the Bristow-Latarjet procedure [12], Hovelius et al were able to demonstrate an arthritis rate of 35% in mild and 14% in moderate and severe cases as defined by Samilson [10].…”

Management and Prognostic Factors for Delayed Reconstruction of Neglected Posterior Shoulder Fracture-Dislocation

“…Arthroplasty is the treatment of choice for those chronic dislocations with defects of larger than 50% of the articular surface accompanying with degeneration of the joint. Besides the technical difficulties and the complications due to the possible soft tissue imbalance, up to 60% successful rates have been reported ( 2 , 4 , 13 ).…”

Posterior dislocation of the shoulder

“…Insgesamt [26] 1994 Rotationsosteotomie 10 6 gut bis hervorragend/ 2 befriedigend/ 2 schlecht (Rowe/Zarin) Sperling et al [48] 2004 Prothese 12 60 1 hervorragend/6 befriedigend/5 unbefriedigend (Neer) Gavriilidis et al [14] 2010 Durch die Seltenheit der Verletzung und die zahlreichen operativen Vorgehensweisen existiert ein Goldstandard in der Versorgung der dorsal verhakten Schulterluxation nicht. Als Therapiegrundsatz kann allgemein jedoch gelten, dass bei instabiler Gelenksituation nach erfolgter Reposition einer dorsal verhakten Luxation, wenn möglich, eine anatomische Defektauffül-lung angestrebt werden sollte.…”