Surgery for trapeziometacarpal osteoarthritis after failure of medical treatment remains controversial. The aim of this study was to determine the long-term results of the MAÏA® trapeziometacarpal prosthesis (Lépine, Genay, France). This was a retrospective clinical and radiographic study of 191 MAÏA® trapeziometacarpal prostheses implanted between 2001 and 2016 from a single centre. The survival rate of the implants at the final follow-up of 12 years (range 17 days to 140 months) was 88%. Median pain score was 1/10. The median Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) score was 20. The rate of major complications was 9% (5% dislocations and 4% loosening) with all dislocations needing revision surgery. The risk of prosthetic dislocation was highest during the first 3 years, most often related to malposition of the trapezium implant. The MAÏA trapeziometacarpal prosthesis represents a long-term solution for surgical treatment of thumb rhizarthrosis. Level of evidence: IV
A 79-year-old right-handed woman presented with an indirect trauma to her left shoulder after a fall down the stairs. X-rays and computed tomography showed a four-part glenohumeral fracture-dislocation with a subcutaneous ectopic location of the humeral head in the retroclavicular space. A reverse total shoulder arthroplasty was performed using a deltopectoral approach with direct superior extraction of the humeral head. The result at 2 years was a subjective shoulder value of 80%, an absolute Constant score of 59, and a relative Constant score of 92/100. To the best of our knowledge, this is the first description in the literature of such a lesion of superior glenohumeral fracture-dislocation and its treatment. Shoulder dislocations are very common injuries in the general population, affecting 23.9 people per 100,000 inhabitants per year in the United States 1 . Shoulder fracture-dislocation are rarer lesion entities than simple dislocations 2 . In regard to the direction of dislocation, anterior dislocations are the most common (72% of cases), followed by posterior dislocation 3 . Some uncommon dislocations were also published, with erect dislocations being a classic example. They represent inferior dislocations of the humeral head, typically resulting from injuries in a hyperabducted position 4 . Rare cases of intrathoracic 5 , superior 6 , or even retroperitoneal 7 dislocations have been reported.A patient was treated for a four-part glenohumeral fracturedislocation with a subcutaneous ectopic location of the humeral head in the retroclavicular space. After a collegial decision by the traumatological team, a reverse total shoulder arthroplasty was performed. The objective of this case report was to present the clinical and radiographic outcomes of the case at 2 years after the procedure.The medical information was anonymized, and the patient's consent for the use of this data was obtained.
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