Surgical management of chronic, unreduced posterior dislocation of the shoulder

Delcogliano, A.; Caporaso, A.; Chiossi, S.; Menghi, Amerigo; Cillo, Mário Sérgio Paulillo de; Delcogliano, Marco

doi:10.1007/s00167-004-0524-6

Cited by 36 publications

(30 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, there is also evidence of good results with a later diagnosis with a great functional improvement. In particular, a study of 2005 [18] showed a case of neglected posterior shoulder dislocation, which underwent surgery with a delay of 19 months, having an optimal functional recovery.…”

Section: Discussionmentioning

confidence: 99%

“…In a major defect, the Neer technique (also known as the modified McLaughlin procedure) proposes the detachment of the subscapularis through an osteotomy and a fixation with cancellous screws [11]. Both techniques are effective in acute and neglected dislocations [17,18]. In smaller bone defects, it is possible to transfer a plication of the subscapularis tendon and to fix it through arthroscopic suture anchors [19,20].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Surgical and Rehabilitative Treatment of Misdiagnosed Posterior Dislocation of the Shoulder: Case Series

Pavone

Caruso

Chisari

et al. 2018

JFMK

View full text Add to dashboard Cite

Abstract:Background: Posterior gleno-humeral joint (GHJ) dislocation is a rare injury accounting for 2.7-3% of all shoulder dislocations. Early detection is the key for an effective treatment. Poor clinical outcomes or prosthetic solutions depend on the severity of the lesions at the time of trauma and worsening of the McLaughlin lesion during the months when the dislocation remains unrecognized or untreated. The aim of the study is to report our experience in treating, and clinically and radiographically evaluate the outcomes of, four neglected posterior GHJ dislocations. Methods: Four patients with inveterate posterior dislocation of the shoulder were evaluated. In three cases, the technique of McLaughlin was performed, and in one case, plication of the subscapularis tendon was performed. During the follow up, patients were clinically evaluated using the Constant shoulder score; an imaging investigation, using X-ray integrated with computed tomography(CT) and magnetic resonance imaging (MRI), was assessed. Results: Following the Constant criteria, treated shoulders reported an excellent outcome with an average score of 91. The mean score of untreated shoulders was 92.5. The humeral appearance that resulted was radiographically well-structured. Surgical treatment with McLaughlin lesion or transposition of the subscapularis were satisfactory from a subjective and objective point of view. To perform surgery soon as possible after the traumatic episode is considered a positive prognostic factor.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Surgical and Rehabilitative Treatment of Misdiagnosed Posterior Dislocation of the Shoulder: Case Series

Pavone

Caruso

Chisari

et al. 2018

JFMK

View full text Add to dashboard Cite

show abstract

“…Allograft reconstruction is preferable to arthroplasty in larger defects in relatively younger patients (Table I). [1,[7][8][9][10][11][12][13][14] For patients who have good bone quality of the residual head and an absence of relevant osteoarthrosis, reconstruction with an allograft represents a viable alternative to hemiarthroplasty or total joint arthroplasty for carefully selected larger defects. However, our follow-up time was too short to recommend whether avascular necrosis or graft collapse would develop, since posterior bilateral dislocation was usually experienced by middle-aged active males.…”

Section: Discussionmentioning

confidence: 99%

One-stage surgical treatment of neglected simultaneous bilateral locked posterior dislocation of shoulder: a case report and literature review

Elmalı

Taşdemir

Sağlam

et al. 2015

Eklem Hastalik Cerrahisi

View full text Add to dashboard Cite

Bilateral posterior or anterior dislocations of the shoulder joint are rare. [1,2] Most posterior shoulder dislocations have been attributed to high energy trauma, seizures or electroconvulsive therapy. [3] Misdiagnosis of this injury may occur in 50% to 79% of patients, most commonly due to lack of clear clinical signs and accurate imaging study findings. [4,5] Computed tomography can quantify the involvement of the articular surface of the humeral head and identify fractures of the tuberosity, surgical neck, or glenoid. In addition, magnetic resonance imaging has been widely used to reveal posterior cuff tears and posterior avulsion lesions.[6] Treatment of neglected posterior dislocation of the shoulder is challenging.This report describes successful treatment of a simultaneous locked bilateral posterior dislocation of the shoulder with an associated large impression fracture of both articular surfaces of the humeral head due to an epileptic seizure. Defect of the humeral head on right side which was more than 40% of the articular surface was treated with osteochondral allograft femoral head, while a lesser articular defect was treated with the modified McLaughlin technique using absorbable suture anchors in the left side in a one-stage operation. ÖZİki taraflı eş zamanlı kilitli arkaya omuz çıkığı oldukça nadirdir. Bu yazıda grand mal tipi epilepsi nöbetinden sonra her iki humerus başının anteromedial yüzeyinde büyük impresyon kırığı ile birlikte redükte edilemeyen iki taraflı arkaya kilitli omuz çıkığı gelişen 59 yaşında erkek bir olgu sunuldu. Direkt grafiler ve bilgisayarlı tomografide sağ tarafta artiküler yüzeyin %40'ından fazla, sol tarafta %30 oranında defekt saptandı. Hastaya tek seansta sağ tarafına femur başı osteokondral allogrefti ile ve kendisine tutunan subskapularis tendon ile birlikte osteotomize edilen tüberkulum minus'un defekt içerisine transferi (modifiye McLaughlin tekniği) uygulandı. On dört aylık izlemde hasta ağrısız, omuz eklemi stabil ve fonksiyonları tatminkar idi.Anahtar sözcükler: İki taraflı omuz çıkığı; kilitli çıkık; tedavi. ABSTRACTSimultaneous bilateral locked posterior dislocation of the shoulder is a rare injury. Herein, we present a 59-year-old male case with a three-month history of an irreducible locked bilateral posterior dislocation of the shoulders with an associated large impression fracture on the anteromedial aspect of both humeral heads after a grand mal type epileptic seizure. Plain X-ray and computed tomograph revealed a defect on the right side more than 40% of the articular surface, and on the left side, 30%. He was treated with a one-stage operation with a reconstruction of femoral head osteochondral allograft on the right side and transfer of the osteotomized tuberculum minus with its attached subscapularis tendon into the defect (modified McLaughlin technique) on the left side. At 14 months during follow-up, the patient was pain-free with stable shoulder joints and satisfactory functionality.

show abstract

“…Dislocation is associated almost always with a reverse Hill-Sachs lesion (an impression defect of anteromedial aspect of the humeral head, also mentioned as ''inverted Hill-Sachs'' or ''McLaughlin'' lesion) [11] and probably with fractures of the posterior aspect of the glenoid rim, fractures of the greater/lesser tuberocity, lesions of the anterior capsule and the subscapularis tendon. Accurate physical examination and radiological evaluation by lateral scapular view or, if tolerated by the patient, by axillary view, in addition to the standard anteroposterior view, are mandatory to reveal the injury [2,8].…”

Section: Discussionmentioning

confidence: 99%

Simultaneous bilateral posterior dislocation of the shoulder: diagnostic problems and management

Iosifidis

Giannoulis

Traios

et al. 2006

Knee Surg Sports Traumatol Arthr

View full text Add to dashboard Cite

We present the case of a patient who sustained simultaneous bilateral posterior dislocation of the shoulder after a possible epileptic fit. The confirmation of the diagnosis was reached only by a computed tomography (CT) scan, after the clinical suspicion. Under general anesthesia, close reduction of both shoulder dislocations was done. Posterior dislocation of the shoulder-especially the bilateral one-is very rare. When the history describes an electric shock or convulsive seizure, any shoulder injury demands a careful clinical and radiological evaluation. It is usually associated with reverse Hill-Sachs lesion (an impression defect of the anteromedial aspect of the humeral head), in which the size determines the treatment options.

show abstract

Surgical management of chronic, unreduced posterior dislocation of the shoulder

Cited by 36 publications

References 8 publications

Surgical and Rehabilitative Treatment of Misdiagnosed Posterior Dislocation of the Shoulder: Case Series

Surgical and Rehabilitative Treatment of Misdiagnosed Posterior Dislocation of the Shoulder: Case Series

One-stage surgical treatment of neglected simultaneous bilateral locked posterior dislocation of shoulder: a case report and literature review

Simultaneous bilateral posterior dislocation of the shoulder: diagnostic problems and management

Contact Info

Product

Resources

About