Near-simultaneous bilateral reverse total shoulder arthroplasty for the treatment of bilateral fracture dislocations of the shoulder

Wendling, Alexander; Vopat, Matthew L.; Yang, Shang-You; Saunders, Bradley

doi:10.1136/bcr-2019-230212

Cited by 8 publications

(8 citation statements)

References 16 publications

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“…Of the seven included articles, one assessed only TSA outcomes; one assessed only HSA outcomes; two reported TSA and HSA outcomes, separated by intervention type; and three studies combined data from TSA and HSA, not separating outcome data by intervention type. Table 2 reports nine case studies for operative outcomes following shoulder arthroplasty for locked dislocation 20,25–32 . Among these case studies, a total of 20 operative outcomes were included.…”

Section: Resultsmentioning

confidence: 99%

Systematic Review and Meta‐Analysis of Locked Posterior Dislocation of the Shoulder Treated with Shoulder Arthroplasty: Improved Outcomes for Total Shoulder Arthroplasty are Associated with Increased Age

Crowley

Ghattas

Collins

et al. 2023

Orthopaedic Surgery

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Locked shoulder dislocations account for up to 5% of shoulder dislocations. These relatively rare injuries are characterized by dislocation of the humeral head from the scapular glenoid cavity with the humeral head incarcerated on the glenoid in a "locked" fashion. Diagnosis is often delayed because of the complexity of clinical presentation and subtle radiographic findings, resulting in locking of the humeral head out of the glenoid cavity with severe functional deficits. Most commonly, there are bony injuries to the glenoid and humeral head that engage and prevent closed reduction. Since few patients present with this injury, evidence-based treatment guidelines have not been established. The objective of this review is to assess postoperative outcomes following shoulder arthroplasty for locked posterior shoulder dislocations (LPSD) to guide best practices for treatment. This systematic review was conducted following PRISMA guidelines, searching the PubMed and Web of Science databases for original articles assessing outcomes following arthroplasty for locked posterior shoulder dislocations. Seven publications that evaluated 102 patients were included. Additionally, nine case studies were included, assessing 20 shoulder arthroplasties. Overall, the analysis demonstrated significant improvement in shoulder pain following total shoulder arthroplasty (TSA) (P = 0.0003). Older operative patient ages for TSA resulted in significantly improved modified Neer outcomes scores and patient satisfaction compared to younger patients (P = 0.047). A positive correlation was noted for the duration of dislocation and necessity for revision surgery following hemiarthroplasty (HSA) and TSA combined and TSA separately. The risk ratios assessing the incidence of postoperative complications (RR = 0.56, 95% CI = 0.28-1.11) and necessity for revision surgery (RR = 0.58, 95% CI = 0.24-1.39) were insignificant but noted outcomes favoring TSA. Data from the included studies show that both TSA and HSA are efficacious at treating locked posterior shoulder dislocation. Postoperative outcomes following TSA versus HSA are similar. TSA may be a more efficacious surgical treatment in elderly patients, with improved outcomes and patient satisfaction scores compared to younger patients. Early diagnosis and treatment of posterior locked dislocations may lead to reduced postoperative complications and revision surgery, signaling the importance of proper injury investigation and early treatment. The role of RSA in the management of locked posterior shoulder dislocation remains to be determined, as there is insufficient clinical outcome data currently in the literature.

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Section: Resultsmentioning

confidence: 99%

Systematic Review and Meta‐Analysis of Locked Posterior Dislocation of the Shoulder Treated with Shoulder Arthroplasty: Improved Outcomes for Total Shoulder Arthroplasty are Associated with Increased Age

Crowley

Ghattas

Collins

et al. 2023

Orthopaedic Surgery

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“…A few case reports have reported on the conservative treatment, closed reduction and percutaneous fixation, open reduction and internal fixation, osteochondral autograft, and HHR for bilateral fractures [ 5 – 7 , 26 – 28 ]. Cases of bilateral RSA for the treatment of simultaneous bilateral proximal humeral fractures have also been reported [ 11 – 13 ]. These reports have described that bilateral RSA improves shoulder function over the short term.…”

Section: Discussionmentioning

confidence: 99%

“…Limited postoperative treatment after bilateral surgery could lead to inferior improvement in shoulder function compared with that for a unilateral injury. However, only a few case reports of simultaneous proximal humerus fractures treated with bilateral RSA have been published [ 11 – 13 ]. Here, we report a case of simultaneous bilateral three- and four-part fractures of the proximal humerus that were treated with single-stage bilateral RSA.…”

Section: Introductionmentioning

confidence: 99%

Simultaneous Bilateral Proximal Humerus Fractures Treated with Single-Stage Bilateral Reverse Shoulder Arthroplasty

Tokuhiro

Urita

Kameda

et al. 2022

Case Reports in Orthopedics

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Introduction. Simultaneous bilateral fractures of the proximal humerus are infrequent, and simultaneous bilateral three- or four-part fractures are even rarer. Reverse shoulder arthroplasty (RSA) is being used increasingly for the treatment of three- and four-part fractures of the proximal humerus. However, treatment of simultaneous bilateral fractures of the proximal humerus is difficult because of concern about postoperative immobilization and rehabilitation. Case Presentation. A 75-year-old woman presented with bilateral shoulder pain subsequent to a fall on the street. Physical examination and radiographs showed simultaneous bilateral fractures of the proximal humerus. The right side fracture was classified as a four-part fracture and the left side fracture as a three-part fracture, according to Neer’s classification. The right shoulder had a risk of avascular necrosis of the humeral head. For the left shoulder, the fracture type had caused ischemia of the humeral head. Single-stage bilateral RSA was performed 9 days after the injury. An abduction pillow was applied for 5 weeks postoperatively. Passive motion exercises were permitted starting at 4 weeks postoperatively, and active range of motion exercises were permitted at 6 weeks postoperatively. At the patient’s most recent follow-up 30 months after surgery, the patient reported no restriction of the activities of daily living. Radiographs revealed no lucent line on the humerus and glenoid components, although bone resorption and superior retraction of the tuberosities on both sides were observed. Conclusions. Single-stage bilateral RSA improved shoulder function, but healing of the greater tuberosity can affect the improvement in external rotation after the operation. Although a long-term follow-up is needed, single-stage bilateral RSA appears to be a viable treatment option.

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“…On diagnosis of his bilateral posterior shoulder fractures, he was referred for an orthopaedic consultation and, subsequently, underwent bilateral sequential reverse geometry shoulder replacements, a significant surgical undertaking but warranted by this injury pattern 1. Postoperative X-rays showed satisfactory appearance of the implants (figure 3).…”

Section: Treatmentmentioning

confidence: 99%

Retching as an unusual cause of bilateral posterior shoulder fracture dislocation

et al. 2022

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Bilateral posterior shoulder fracture dislocation is a debilitating injury and is quite rare. This injury pattern has been described in the literature as either secondary to seizure, electrocution or major trauma. We present a case of an elderly man who appears to have sustained the injury after an episode of retching and vomiting. With our patient witnessed closely throughout and no trauma, electrocution or seizure activity reported, we propose that the violent action of retching and vomiting not only has the potential to cause this injury pattern but also was the only credible cause in our patient. This case not only adds to the list of potential injuries caused by retching and vomiting but also questions the validity of a previously limited list of modes-of-injury for posterior shoulder fracture dislocation.

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Near-simultaneous bilateral reverse total shoulder arthroplasty for the treatment of bilateral fracture dislocations of the shoulder

Cited by 8 publications

References 16 publications

Systematic Review and Meta‐Analysis of Locked Posterior Dislocation of the Shoulder Treated with Shoulder Arthroplasty: Improved Outcomes for Total Shoulder Arthroplasty are Associated with Increased Age

Systematic Review and Meta‐Analysis of Locked Posterior Dislocation of the Shoulder Treated with Shoulder Arthroplasty: Improved Outcomes for Total Shoulder Arthroplasty are Associated with Increased Age

Simultaneous Bilateral Proximal Humerus Fractures Treated with Single-Stage Bilateral Reverse Shoulder Arthroplasty

Retching as an unusual cause of bilateral posterior shoulder fracture dislocation

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