Posterior Fracture Dislocation of the Shoulder: A Modified McLaughlin Procedure

Abstract

The modified McLaughlin procedure demonstrates excellent clinical and radiographic results after posterior fracture dislocation of the shoulder with a reverse Hill-Sachs lesion between 25% and 45%.

Recurrent Shoulder Posteroinferior Subluxation Status Post Reverse Remplissage

“…Surgical treatment is recommended for defects involving 20% to 45% of the humeral head articular surface. Operative management options for posterior fracturedislocations include open reduction and internal fixation, the McLaughlin procedure, the modified McLaughlin procedure, and hemiarthroplasty [9][10]. Hemiarthroplasty is typically reserved for large articular surface defects, greater than 50%, or other severe damage to the humeral head [11].…”

“…The procedure involves dissecting the lesser tuberosity of the humeral head, along with the insertion of the subscapularis tendon, and attaching them to the humeral head defect. This holds the humeral head in constant internal rotation to counteract the immense external rotatory force during seizure activity [8][9][10][11]. Currently, these procedures are primarily done arthroscopically [8].…”

Bilateral posterior fracture-dislocation of the shoulder after epileptic seizures: A case report

“…Treatment modalities include rotational osteotomy of the proximal humerus, transposition of the subscapularis tendon or the lesser tuberosity into the defect, or bone grafting. Shoulder arthroplasty should be reserved for large defects and neglected dislocations [15][16][17].…”

Standing Tall on Their Shoulders: Essential Eponyms in Shoulder Surgery

“…Overall, the data have shown an improvement in success rate and clinical results when the lesser tuberosity is transferred along with the subscapularis. 67,68 This has led to a modified form of the initial procedure described that continues to hold Dr McLaughlin’s name.…”