Posterior Dislocation of the Shoulder: The Light-Bulb Sign

Koutserimpas, Christos; Piagkou, Maria; Karaiskos, Ilias; Chronopoulos, Efstathios; Arkoudis, Nikolaos-Achilleas

doi:10.7759/cureus.47800

Cited by 2 publications

(1 citation statement)

References 17 publications

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“…A thorough radiographic assessment is essential because 50% to 80% of posterior shoulder dislocations are missed on their initial assessment 14 . The true AP view should be closely evaluated for signs of a posterior dislocation, including the "light bulb sign" indicating the humeral head aligned with the axis of the shaft because of internal rotation 15 . The scapular Y view should be assessed for posterior acromial morphology because recent evidence has highlighted a strong correlation between a high and flat posterior acromion and PSI 16 .…”

Section: Imaging Assessmentmentioning

confidence: 99%

Management of Bone Loss in Posterior Glenohumeral Shoulder Instability

Testa,

van der List,

Waterman

et al. 2024

JBJS Reviews

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» Posterior glenohumeral instability is relatively uncommon compared with anterior instability, but is becoming an increasingly recognized and surgically managed shoulder pathology.» Soft-tissue stabilization alone may not be sufficient in patients who present with substantial bone loss to the posterior glenoid and/or the anterior humeral head.» For posterior glenoid defects, posterior glenoid osteoarticular augmentation can be used, and posterior glenoid opening wedge osteotomy can be considered in cases of posterior instability with pathologic retroversion.» For humeral head lesions, several surgical treatment options are available including subscapularis transposition into the humeral head defect, autograft or allograft reconstruction, humeral rotation osteotomy, and shoulder arthroplasty.

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Section: Imaging Assessmentmentioning

confidence: 99%

Management of Bone Loss in Posterior Glenohumeral Shoulder Instability

Testa,

van der List,

Waterman

et al. 2024

JBJS Reviews

View full text Add to dashboard Cite

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Irreducible Posterior Shoulder Dislocation With Concomitant Fracture of Both the Greater and Lesser Tuberosity: An Extremely Rare Shoulder Injury

Kotsalis,

Georgountzos,

Kechagias

et al. 2024

Cureus

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Posterior shoulder dislocation is a relatively rare injury representing only 5% of all shoulder dislocations. It is usually the result of a high-energy trauma or an epileptic seizure. Diagnosis is challenging with half of these injuries missed in the emergency room (ER). Often the dislocation is accompanied by a lesser tuberosity fracture as a result of the impact between the posterior glenoid and the proximal humerus. Additionally, fractures of the greater tuberosity or even the metaphysis are extremely rare, and their treatment remains challenging. We present a rare case of posterior locked shoulder dislocation with a concomitant lesser and greater tuberosity fracture in a young patient. A 29-year-old male was brought to the ER following a motor vehicle accident. The patient reported significant pain and inability to move his left shoulder. The arm was locked in an internal rotation and was neurovascularly intact. Simple radiographs revealed a locked posterior dislocation with fractures of both the lesser and greater tuberosity. The CT scan confirmed the fracture pattern and excluded metaphyseal fracture. Surgical treatment was decided. Under general anesthesia and a classic thoracodeltoid approach, both tuberosities were recognized and the dislocation was gently reduced. Fixation of the tuberosities with an anatomic plate and Ethibond No. 5 sutures was performed. He was discharged the next day with a 30-degree abduction sling cast. He was instructed to perform passive shoulder and scapula exercises once a day. After one month, the sling was removed and active elevation and rotation exercises were started. Plane X-rays were performed at one, six, and twelve months. The reduction remained stable and the patient recovered full range of motion with a slight loss of external rotation (10 degrees) compared to the contralateral limb. He returned to his previous activities without any complications. Posterior shoulder dislocations with additional fractures of the tuberosities are rare and severe injuries requiring open surgery as the humeral head may remain locked prohibiting closed reduction. Even after the reduction, the stable fixation of the tuberosities is crucial for shoulder stability and postoperative clinical and functional results.

show abstract

Posterior Dislocation of the Shoulder: The Light-Bulb Sign

Cited by 2 publications

References 17 publications

Management of Bone Loss in Posterior Glenohumeral Shoulder Instability

Management of Bone Loss in Posterior Glenohumeral Shoulder Instability

Irreducible Posterior Shoulder Dislocation With Concomitant Fracture of Both the Greater and Lesser Tuberosity: An Extremely Rare Shoulder Injury

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