Posterior shoulder dislocations

An exceptional case of posterior shoulder fracture dislocation in patient with recurrent anterior dislocation forming “Mirror Hill‐Sachs lesion”

“…9 PSD are rare, easily missed or delayed diagnosed in 50%-70% of cases. 10 Missed PSD can be attributable to (a) infrequency, (b) subtle clinical examination findings, (c) clinician underestimating the importance of patient presentation, (d) inadequate initial imaging. 8,10,11 Few signs to look for PSD in AP view include a bulb sign owing to internally rotated humerus and no overlap of humeral head over glenoid.…”

“…10 Missed PSD can be attributable to (a) infrequency, (b) subtle clinical examination findings, (c) clinician underestimating the importance of patient presentation, (d) inadequate initial imaging. 8,10,11 Few signs to look for PSD in AP view include a bulb sign owing to internally rotated humerus and no overlap of humeral head over glenoid. 8 However, in patients with humeral engagement, glenohumeral overlap can be found as in our patient and it increases the chances of dislocation being overlooked F I G U R E 1 X-ray AP view postseizure taken at the emergency department…”

“…Over 90% of shoulder dislocations are anterior, occurring mostly in young men with high‐energy trauma 9 . PSD are rare, easily missed or delayed diagnosed in 50%‐70% of cases 10 . Missed PSD can be attributable to (a) infrequency, (b) subtle clinical examination findings, (c) clinician underestimating the importance of patient presentation, (d) inadequate initial imaging 8,10,11 …”

Posterior Glenohumeral Capsular Reconstruction With Modified McLaughlin for Chronic Locked Posterior Dislocation

“…In this paper, we describe the surgical technique for addressing the chronic posteriorly dislocated shoulder with capsular insufficiency and a large reverse Hill–Sachs defect. Although the shoulder is the most commonly dislocated joint in the body, the majority of these are anterior dislocations, with only 2% to 4% occurring posteriorly 11 . In addition, it has been reported that in 40% to 90% of cases, these chronic dislocations also are accompanied by significant bone loss of the anteromedial humeral head (also known as a “reverse Hill–Sachs lesion”) 12 , 15 .…”

“…Issues surrounding the most recent dislocation event including duration of dislocation, mechanism of injury, and previous episodes of instability are documented. Pain to the posterior aspect of the shoulder rather than instability is the most common complaint of patients with recurrent instability 3 , 11 , 12 . Patients with a chronically dislocated shoulder complain of persistent pain and commonly present with a posterior deformity of the humeral head with a flattening at the anterior aspect of the shoulder and oftentimes a fixed internal rotation deformity with limited abduction 13 .…”