Treatment and Follow-Up of a Locked Posterior Shoulder Dislocation

Schmal, Hagen; Klemt, C.; Südkamp, Norbert P.

doi:10.1007/s00068-004-1326-8

Cited by 2 publications

(2 citation statements)

References 8 publications

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“…The most common indications in the arthroplasty/reversed total arthroplasty group were comminuted fractures (four-part fracturedislocations), impression fractures greater than 45%, advanced patient age, concomitant osteoarthritis, presence of an irreparable rotator cuff tear, and presence of conditions, such as osteogenesis imperfecta. [ 8 , 15 , 16 , 19 - 27 ]…”

Section: Discussionmentioning

confidence: 99%

“…[39] The most common indications in the arthroplasty/reversed total arthroplasty group were comminuted fractures (four-part fracturedislocations), impression fractures greater than 45%, advanced patient age, concomitant osteoarthritis, presence of an irreparable rotator cuff tear, and presence of conditions, such as osteogenesis imperfecta. [8,15,16,[19][20][21][22][23][24][25][26][27] Trauma is the most common cause of bilateral locked shoulder dislocation (n=52). Still, considering that, in one article, 26 of 35 patients were traumatic, disregarding this article, the most common cause is epileptic seizure (n=41).…”

Section: Discussionmentioning

confidence: 99%

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Bilateral locked posterior shoulder dislocation overlooked for 15 months treated with the modified McLaughlin procedure: A case report

Saylık¹,

Gokkus

2022

Jt Dis Relat Surg

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Neglected bilateral posterior shoulder dislocation is a rare injury caused primarily by an epileptic seizure. The injury is usually associated with a reverse Hill-Sachs lesion in the anteromedial aspect of the humeral head. The modified McLaughlin technique may avoid instability and osteoarthritis when 20 to 40% of the articular surface is affected by reverse Hill-Sachs. In this article, we present the clinical results of a case overlooked in the literature for the longest time, i.e., for 15 months. A 46-year-old male patient was receiving treatment for epilepsy for five years. There was no fall or trauma in the four seizures he had during this time. The last seizure was 15 months ago. When the patient presented to our clinic, both shoulders were symmetrically deformed, the anterior shoulder contour disappeared (empty socket sign), and there was a loss of upper contour. The computed tomography (CT) scan revealed a posteriorly locked dislocation with a reverse Hill-Sachs lesion in 32% of the left shoulder and 36% of the right shoulder. We applied the modified McLaughlin procedure to the dominant right shoulder and, two months later, we used it to the left shoulder (with a graft taken from the anterior superior iliac spine). At one-year of follow-up, both shoulders were moderately functional: forward elevation left 70° and right 50°, abduction left 40° and right 60°, and internal rotation: the back of the hand could touch the fifth lumbar vertebra. Meanwhile, the patient did not suffer from recurrent dislocation. The pre- and postoperative Constant-Murley Scores for the right and left shoulder were 30/52 and 11/48, respectively. Although the operational outcomes using the modified McLaughlin technique were not ideal, with no recurrence, the patient seemed to be satisfied with this outcome. In conclusion, in neglected locked shoulder fracture-dislocations, the modified McLaughlin technique is a method that can respond to the pathophysiology by eliminating reverse Hill–Sachs lesion.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Bilateral locked posterior shoulder dislocation overlooked for 15 months treated with the modified McLaughlin procedure: A case report

Saylık¹,

Gokkus

2022

Jt Dis Relat Surg

View full text Add to dashboard Cite

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The aetiology of posterior glenohumeral dislocations and occurrence of associated injuries

Holton

Cassar-Gheiti

Hanna

et al. 2019

The Bone & Joint Journal

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Aims The glenohumeral joint is the most frequently dislocated articulation, but possibly due to the lower prevalence of posterior shoulder dislocations, approximately 50% to 79% of posterior glenohumeral dislocations are missed at initial presentation. The aim of this study was to systematically evaluate the most recent evidence involving the aetiology of posterior glenohumeral dislocations, as well as the diagnosis and treatment. Materials and Methods A systematic search was conducted using PubMed (MEDLINE), Web of Science, Embase, and Cochrane (January 1997 to September 2017), with references from articles also evaluated. Studies reporting patients who experienced an acute posterior glenohumeral joint subluxation and/or dislocation, as well as the aetiology of posterior glenohumeral dislocations, were included. Results A total of 54 studies met the inclusion criteria. In total, 182 patients were included in this analysis; study sizes ranged from one to 66 patients, with a mean age of 44.2 years (sd 13.7). There was a higher proportion of male patients. In all, 216 shoulders were included with 148 unilateral injuries and 34 bilateral. Seizures were implicated in 38% of patients (n = 69), with falls, road traffic accidents, electric shock, and iatrogenic reasons also described. Time to diagnosis varied across studies from immediate up to a delay of 25 years. Multiple associated injuries are described. Conclusion This review provides an up-to-date insight into the aetiology of posterior shoulder dislocations. Our results showed that seizures were most commonly implicated. Overall, reduction was achieved via open means in the majority of shoulders. We also found that delayed diagnosis is common.

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Treatment and Follow-Up of a Locked Posterior Shoulder Dislocation

Cited by 2 publications

References 8 publications

Bilateral locked posterior shoulder dislocation overlooked for 15 months treated with the modified McLaughlin procedure: A case report

Bilateral locked posterior shoulder dislocation overlooked for 15 months treated with the modified McLaughlin procedure: A case report

The aetiology of posterior glenohumeral dislocations and occurrence of associated injuries

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