Open reduction of old unreduced anterior shoulder dislocations: a case series including 10 patients

Akıncı, Ozan; Kayalı, Cemil; Akalın, Yavuz

doi:10.1007/s00590-009-0495-x

Cited by 14 publications

(9 citation statements)

References 10 publications

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“…There exists no consensus on the treatment of chronic shoulder dislocations, but it is recommended that closed reduction only be attempted up to six weeks post-dislocation due to the high risk of iatrogenic fractures and neurovascular damage beyond this time. Recent reports indicate that open reduction of dislocations >6 weeks is associated with satisfactory outcomes [ 17 , 18 ]. Physicians should be aware that late surgery may increase the relative risk of avascular necrosis by as much as fivefold when compared to surgery within 48 hours [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Chronic Bilateral Symmetric Anterior Shoulder Dislocation Secondary to Seizures in Chikungunya Encephalitis

Budhoo¹,

Mohammed²,

Baiju³

et al. 2022

Cureus

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Bilateral shoulder dislocations are a rare occurrence and can be categorized as either symmetric (both humeral heads dislocate in the same direction) or asymmetric (wherein the humeral heads dislocate in different directions). Shoulder dislocations may be overlooked if they are the result of systemic injury; if diagnosed >21 days after occurring, they are considered chronic dislocations.We describe the case of a 31-year-old male who presented with an eight-week history of bilateral shoulder pain. His onset of pain coincided with a seizure secondary to Chikungunya encephalitis. Clinical and radiological examination demonstrated bilateral symmetric anterior shoulder dislocation with associated greater tuberosity fractures and extensive callus formation bilaterally. Open surgical management was performed first on the left shoulder via the deltopectoral approach. The callus was removed, the greater tuberosity fragment lifted off, reattached to the original position, and held in place with sutures and proximal humeral locking plates. The right shoulder was reduced six weeks after the left shoulder due to patient preference; the reduction utilized the same approach as with the left shoulder. Post-operatively the patient was immobilized, and physiotherapy commenced. He achieved a satisfactory range of motion four months post-operation.Physicians should be cognizant that shoulder pain after a convulsive seizure may signify shoulder dislocation. Thorough clinical and radiological examinations are warranted in such an instance. There exists no consensus on the treatment of chronic shoulder dislocations, but it is recommended that closed reduction only be attempted up to six weeks post-dislocation due to the high risk of iatrogenic fractures and neurovascular damage beyond this time.

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Section: Discussionmentioning

confidence: 99%

Chronic Bilateral Symmetric Anterior Shoulder Dislocation Secondary to Seizures in Chikungunya Encephalitis

Budhoo¹,

Mohammed²,

Baiju³

et al. 2022

Cureus

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“…As almost all previous reported cases of missed anterior shoulder dislocation were associated with an intact coracoid process, several authors suggested - after performing glenohumeral open reduction - carrying out an osteotomy of the coracoid process, and using it to achieve either a Latarjet [ 14 , 17 ] or a Boytchev procedure [ 17 ]. Protection of the repair with temporary acromiohumeral or glenohumeral pin transfixion has been recommended, particularly in patients with seizure, or whenever stability was in doubt [ 17 - 18 ]. Limited incision of the subscapularis - with preservation of its distal continuity and protection of the anterior circumflex humeral vessels - has been recommended to avoid impairment of humeral head vascularity during open reduction of missed anterior dislocations [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Missed Bilateral Anterior Shoulder Dislocation With Bilateral Coracoid Fracture and Unilateral Long Head of Biceps Rupture

Chamseddine

Mouchantaf

Freiha

et al. 2020

Cureus

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Missed or chronic bilateral anterior shoulder dislocation is a rare presentation, usually secondary to epileptic attack. We present herein an exceptional case of this injury pattern, associated with bilateral displaced fracture of the coracoid process, and unilateral rupture of the long head of biceps. Treatment consisted of open reduction through osteotomy of the lesser tuberosity, with additional stabilization of the glenohumeral joint, using the Latarjet procedure by transposition of the coracoid fragment with its attached conjoint tendon to the antero-inferior glenoid rim. Rupture of the long head of the biceps required tenodesis. Temporary glenohumeral pin transfixation was performed for residual instability at the end of the procedure. Patients with postictal shoulder pain, discomfort, or disability should be investigated with adequate radiographs, in addition to CT scan or MRI when needed. Early diagnosis allows for safe closed reduction, and helps avoid late and more complex surgical treatment required for missed or chronic dislocations.

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“…Under certain circumstances, anterior dislocation of the shoulder may go undiagnosed and may thus left untreated for a variable length of time [1]. A chronic dislocation of the shoulder is defined when the diagnosis is delayed by more than 3 weeks [2,3]. Chronic locked anterior dislocations of the glenohumeral joint is a rare condition and is usually related to trauma of the affected shoulder [4,5].…”

Section: Introductionmentioning

confidence: 99%

Reversed Shoulder Arthroplasty on Chronic Glenohumeral Dislocations: A Small Retrospective Cases Series

Miguel¹,

Henrique²,

Pinheiro³

et al. 2018

J Musculoskelet Disord Treat

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Introduction: Anterior dislocation of the shoulder may go undiagnosed and may thus left untreated for a variable length of time. Chronic locked anterior dislocations of the glenohumeral joint is a rare condition. Its diagnosis and management can be challenging. Reverse shoulder arthroplasty has yelded satisfactory outcomes in patients with cuff tear arthropaty and other degenerative changes of the shoulder joint. The concept of this implant theoretically allows stabilization of the dislocated shoulder independently of soft tissues defects.

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Open reduction of old unreduced anterior shoulder dislocations: a case series including 10 patients

Cited by 14 publications

References 10 publications

Chronic Bilateral Symmetric Anterior Shoulder Dislocation Secondary to Seizures in Chikungunya Encephalitis

Chronic Bilateral Symmetric Anterior Shoulder Dislocation Secondary to Seizures in Chikungunya Encephalitis

Missed Bilateral Anterior Shoulder Dislocation With Bilateral Coracoid Fracture and Unilateral Long Head of Biceps Rupture

Reversed Shoulder Arthroplasty on Chronic Glenohumeral Dislocations: A Small Retrospective Cases Series

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