Incidence of Associated Injury in Posterior Shoulder Dislocation

Rouleau, Dominique M.; Hébert‐Davies, Jonah

doi:10.1097/bot.0b013e3182243909

Cited by 120 publications

(93 citation statements)

References 89 publications

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“…Rotator cuff tear injuries are present in 13%. [5] Less frequent associated injuries are brachial plexopathy and axillary nerve palsy. [6] To date, because of the lack of high-level evidence, there are no definitive management guidelines for PSD.…”

Section: Discussionmentioning

confidence: 99%

Frozen shoulder or missed posterior dislocation?

Leijnen¹

2016

S Afr J SM

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The clinical presentation of a missed posterior shoulder dislocation has similarities with an idiopathic frozen shoulder masking proper diagnosis at the time of injury. We report a case of a 48-year-old woman with shoulder pain which demonstrates the importance of correct initial diagnosis and management. The glenohumeral (GH) joint consists of the humeral head that articulates in the glenoid fossa of the scapula, surrounded by several static and dynamic structures. It is the most mobile joint of the human body which makes it vulnerable to dislocation in all directions. Posterior shoulder dislocation (PSD) is less common than anterior. The rarity of this pathology together with the restrictions of standard view X-rays often leads to the diagnosis being missed. Case reportA 48-year-old woman presented with 4 months of spontaneous progressive pain and limited range of motion of the right shoulder. Her pain was aggravated by movement and impacts, particularly those activities associated with daily living. She was unable to lie on her right side but did not complain of any pain at night. She had no history of trauma although she recently started experiencing episodes of syncope. Further to this, her medical history consisted of hypertension, hypercholesterolaemia, asthma and previous left frozen shoulder.Upon clinical examination she held the right upper limb in internal rotation with the elbow in flexed position. There was diffuse, mild tenderness over the anterolateral side of the shoulder. Range of motion was limited to 5 degrees of passive and active abduction. External rotation was not possible. Other shoulder tests were impossible to implement. X-rays showed normal proportions of the GH joint with the humeral head articulating in the glenoid. On the anterior side of the humeral head a medium sized dent was visible, suggestive of a reverse Hill-Sachs lesion. The differential diagnosis was an overlooked posterior shoulder dislocation or adhesive capsulitis.

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Section: Discussionmentioning

confidence: 99%

Frozen shoulder or missed posterior dislocation?

Leijnen¹

2016

S Afr J SM

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“…In particular, posterior GHJ dislocation fracture represents 0.9% of all dislocation fractures of the shoulders [4]. Bone fracture presents in 34% of the cases; the neck and lesser and greater tuberosity are the most common [8]. A reverse Hill-Sachs lesion, also called a McLaughlin lesion, is defined as an impaction fracture of the anteromedial aspect of the humeral head lesion and has been reported in 29% of cases.…”

Section: Introductionmentioning

confidence: 99%

“…A reverse Hill-Sachs lesion, also called a McLaughlin lesion, is defined as an impaction fracture of the anteromedial aspect of the humeral head lesion and has been reported in 29% of cases. A rotator cuff tear was involved in 13-20% of the patients [8,9].…”

Section: Introductionmentioning

confidence: 99%

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Surgical and Rehabilitative Treatment of Misdiagnosed Posterior Dislocation of the Shoulder: Case Series

Pavone

Caruso

Chisari

et al. 2018

JFMK

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Abstract:Background: Posterior gleno-humeral joint (GHJ) dislocation is a rare injury accounting for 2.7-3% of all shoulder dislocations. Early detection is the key for an effective treatment. Poor clinical outcomes or prosthetic solutions depend on the severity of the lesions at the time of trauma and worsening of the McLaughlin lesion during the months when the dislocation remains unrecognized or untreated. The aim of the study is to report our experience in treating, and clinically and radiographically evaluate the outcomes of, four neglected posterior GHJ dislocations. Methods: Four patients with inveterate posterior dislocation of the shoulder were evaluated. In three cases, the technique of McLaughlin was performed, and in one case, plication of the subscapularis tendon was performed. During the follow up, patients were clinically evaluated using the Constant shoulder score; an imaging investigation, using X-ray integrated with computed tomography(CT) and magnetic resonance imaging (MRI), was assessed. Results: Following the Constant criteria, treated shoulders reported an excellent outcome with an average score of 91. The mean score of untreated shoulders was 92.5. The humeral appearance that resulted was radiographically well-structured. Surgical treatment with McLaughlin lesion or transposition of the subscapularis were satisfactory from a subjective and objective point of view. To perform surgery soon as possible after the traumatic episode is considered a positive prognostic factor.

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“…1 Reverse Hill-Sachs lesions can contribute to recurrent instability of the shoulder, especially when comprising greater than 25% of the articular surface of the humeral head. [1][2][3] Posterior locked shoulder dislocations are rare, accounting for fewer than 3% of all shoulder dislocations, and they are usually caused by epileptic seizures, high-energy trauma, or electrocution. 4 Recurrent or persistent shoulder instability is an indication for surgery.…”

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confidence: 99%

Arthroscopic Reduction and Balloon Humeroplasty in the Treatment of Acute Hill-Sachs Lesions

Ratner

Backes

Tokish

2016

Arthroscopy Techniques

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Shoulder instability is often associated with an impaction fracture of the humeral head, commonly referred to as a "Hill-Sachs lesion." This lesion is present in both anterior and posterior instability. Forty percent to 90% of anterior shoulder dislocations have associated Hill-Sachs lesions, whereas 29% to 86% of posterior shoulder dislocations have reverse Hill-Sachs lesions. Both of these lesions can contribute to recurrent instability of the shoulder and require surgery to be treated. Currently, the most common procedures to address Hill-Sachs lesions are the remplissage procedure (transfer of the infraspinatus into the posterior humeral head defect), capsular shift, disimpaction technique, humeral head resurfacing, bone block transfer, or shoulder arthroplasty. Reverse Hill-Sachs lesions are managed with similar procedures, such as the remplissage-equivalent technique described by McLaughlin, which involves transfer of the subscapularis tendon to fill the humeral head defect. The procedure has the advantage of "exteriorizing" the humeral head defect, but in the case of large lesions, it can result in significant loss of the articulating articular surface. The purpose of this article is to describe an arthroscopically assisted disimpaction technique with supplemental grafting using a balloon osteoplasty technique for a reverse Hill-Sachs lesion with bone cement to support and maintain the reduction.

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Incidence of Associated Injury in Posterior Shoulder Dislocation

Abstract: Our results suggest the amount of associated injuries related to posterior shoulder dislocation is far greater than thought. We propose an investigation algorithm for acute posterior shoulder dislocations.

Cited by 120 publications

References 89 publications

Frozen shoulder or missed posterior dislocation?

Frozen shoulder or missed posterior dislocation?

Surgical and Rehabilitative Treatment of Misdiagnosed Posterior Dislocation of the Shoulder: Case Series

Arthroscopic Reduction and Balloon Humeroplasty in the Treatment of Acute Hill-Sachs Lesions

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