Reliability of a New Standardized Measurement Technique for Reverse Hill-Sachs Lesions in Posterior Shoulder Dislocations

Moroder, Philipp; Tauber, Mark; Hoffelner, Thomas; Auffarth, Alexander; Korn, Gundobert; Bogner, Robert; Hitzl, Wolfgang; Resch, Herbert

doi:10.1016/j.arthro.2012.10.016

Cited by 39 publications

(40 citation statements)

References 17 publications

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“…Some authors suggest that a head-split fracture is present if at least 20% of the articular surface is involved [27]. However, area estimations of the humeral articular surface are unreliable and accurate measurement is difficult with conventional software [17].…”

Section: Pathomorphology and Classificationmentioning

confidence: 99%

Head-split fractures of the proximal humerus

et al. 2019

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Section: Pathomorphology and Classificationmentioning

confidence: 99%

Head-split fractures of the proximal humerus

et al. 2019

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“…The development of advanced imaging modalities, such as the CT scanning with 3D Joints reconstruction, allowed better assessment of the humeral head bone loss. 19 A variety of operations have been proposed as possible solutions for the treatment of these complex injuries. Various surgical approaches have been reported including arthroscopic repair, open nonanatomical muscle/tendon transfers, 9,12,21,22 rotational osteotomies of the proximal humerus, 23 anatomical bone grafting, [24][25][26][27] and shoulder arthroplasty.…”

Section: Discussionmentioning

confidence: 99%

All-Arthroscopic McLaughlin's Procedure in Patients with Reverse Hill–Sachs Lesion Caused by Locked Posterior Shoulder Dislocation

Brilakis

Malahias

Patramani

et al. 2019

Joints

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Purpose This study aims to investigate the clinical and functional outcomes of the all-arthroscopic McLaughlin procedure in a clinical series of patients suffering by neglected locked posterior shoulder dislocation. Methods A retrospective clinical study based on prospectively collected data was conducted in a single center regarding 10 patients with neglected locked posterior shoulder dislocation and concomitant reverse Hill–Sachs lesion, who were treated with the all-arthroscopic Mclaughlin procedure. The average humeral bone defect was 39 ± 7% according to the preoperative computed tomography evaluation. The mean time of follow-up was 77 ± 16 months (range, 63–104 months). Results No patient had suffered a new dislocation, whereas all of them were satisfied with the surgical outcome and returned to their previous activities of daily living. External rotation was restored to every patient studied from 0 degrees at the baseline. At the last follow-up, the median external rotation beside the body was 90 degrees (range, 50–90 degrees; p < 0.01) and the respective measurement at 90 degrees of abduction was 90 degrees (range, 80–90 degrees; p < 0.01). The active forward flexion was increased (p < 0.01), from 60 degrees (range, 30–180 degrees) at the baseline to 180 degrees (range, 160–180 degrees) at the last follow-up and the internal rotation was gained (p < 0.01) from the level of buttock (range, lateral thigh–T12) at the baseline to the T11 level (range, T7–L3) at the last follow-up. The median UCLA score was increased from 8 (range, 4–22) to 35 (range, 33–35; p < 0.01) and the Oxford instability score from 5 (range, 3–16) to 46 (range, 43–48; p < 0.01), respectively. Conclusion The arthroscopic McLaughlin procedure in substantial reverse Hills–Sachs lesion caused by locked posterior dislocation leads to excellent clinical and functional results in the long-term follow-up. Level of Evidence This is a therapeutic study, case series with no comparison group, Level IV.

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“…The size of the reverse Hill-Sachs lesions was quantified using axial CT sets, as described by Moroder et al. 6 ( Fig. 3 ) and the average size of the defects was 27%, with a defect size range varying from 20% to 40%.…”

Section: Methodsmentioning

confidence: 99%

Transfer of the lesser tuberosity for reverse Hill-Sachs lesions after neglected posterior dislocations of the shoulder: A retrospective clinical study of 13 cases

Demіrel¹,

Erşen²,

Karademir³

et al. 2017

Acta Orthopaedica et Traumatologica Turcica

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ObjectiveThis study aimed to present middle-term functional and radiological outcomes of the transfer of the lesser tuberosity in the management of reverse Hill-Sachs lesions following posterior dislocations of the shoulder.Patients and methodsWith a diagnosis of neglected posterior shoulder dislocation (8 locked, 5 recurrent), 13 male patients (age range: 28–72; mean age: 39.3 years) who underwent the transfer of the lesser tuberosity due to reverse Hill-Sachs lesions, were retrospectively reviewed based on functional and radiological data. The etiologies were: epilepsy in 9 patients, a traffic accident in 2 patients, and fall in 2 patients. To assess the patients' functional level, American Shoulder and Elbow Surgeons (ASES) and Constant Scores were used, and the patients' range of motion at the last follow-up was measured. To evaluate the development of arthrosis, the final follow-up control plain radiographs were examined. The average size of the defects calculated from the axial computed tomography sets was 27% (range: 20%–40%).ResultsThe average length of follow-up was 30 months (range: 12–67 months). At the last follow-up visit, the main ASES and Constant Scores were 78 and 85, respectively, and the average degrees of flexion, abduction, and external rotation were 163°, 151°, and 70° respectively. The concentric reduction was observed postoperatively.ConclusionMcLaughlin procedure appears to be a safe and effective method in the treatment of neglected posterior shoulder dislocations with reverse Hill-Sachs lesion.Level of EvidenceLevel IV, Therapeutic study.

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Reliability of a New Standardized Measurement Technique for Reverse Hill-Sachs Lesions in Posterior Shoulder Dislocations

Cited by 39 publications

References 17 publications

Head-split fractures of the proximal humerus

Head-split fractures of the proximal humerus

All-Arthroscopic McLaughlin's Procedure in Patients with Reverse Hill–Sachs Lesion Caused by Locked Posterior Shoulder Dislocation

Transfer of the lesser tuberosity for reverse Hill-Sachs lesions after neglected posterior dislocations of the shoulder: A retrospective clinical study of 13 cases

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