Balloon treatment of posterior shoulder dislocation with reverse Hill–Sachs injury: description of a new technique

Jacquot, Frédéric; Costil, Vanessa; Werther, Jean-Roger; Atchabahian, Arthur; Sautet, Alain; Féron, Jean-Marc; Doursounian, Levon

doi:10.1007/s00264-013-1877-6

Cited by 15 publications

(9 citation statements)

References 19 publications

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“…The modified McLaughlin technique is a frequently used technique for cases with an HSL in the range of 25% to 50%. 7 , 9 , 13 , 34 The defect is filled by the osteotomized lesser tubercle with this technique. A graft can be added to the modified McLaughlin procedure according to the size of the defect.…”

Section: Discussionmentioning

confidence: 99%

Locked posterior dislocation of the shoulder

2018

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Locked posterior dislocation of the shoulder is very rare. Seizures and trauma are the most common causes of this injury.There is no current benchmark treatment strategy for these rare cases.This study has shown that reconstruction of the shoulder joint in an anatomical way in acute and chronic cases up to 16 weeks provides good results.The purpose of this study is to evaluate the results of different treatment procedures with outcomes and to compare the results of the same procedures in acute and chronic cases.Cite this article: EFORT Open Rev 2017;3:15–23. DOI: 10.1302/2058-5241.3.160089.

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Section: Discussionmentioning

confidence: 99%

Locked posterior dislocation of the shoulder

2018

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“…They used 18 cadaveric humeri and were able to show a 99.3% reduction to the original humeral head volume. Finally, Jacquot et al 14 were the first surgeons in the literature to perform humeroplasty on reverse Hill-Sachs lesions with balloon kyphoplasty and bone cement in live patients. They performed the operation in 3 patients and used fluoroscopic guidance to aid in the placement of the kyphoplasty balloon to ensure adequate reduction.…”

Section: Discussionmentioning

confidence: 99%

“…Stachowicz et al 13 described the same technique used on cadavers. To our knowledge, there is only one mention of this technique being used in live patients: Jacquot et al 14 used fluoroscopic guidance to perform a humeroplasty on 4 different shoulders with reverse Hill-Sachs lesions. However, they did not use arthroscopy to aid in the reduction.…”

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confidence: 99%

Arthroscopic Reduction and Balloon Humeroplasty in the Treatment of Acute Hill-Sachs Lesions

Ratner

Backes

Tokish

2016

Arthroscopy Techniques

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Shoulder instability is often associated with an impaction fracture of the humeral head, commonly referred to as a "Hill-Sachs lesion." This lesion is present in both anterior and posterior instability. Forty percent to 90% of anterior shoulder dislocations have associated Hill-Sachs lesions, whereas 29% to 86% of posterior shoulder dislocations have reverse Hill-Sachs lesions. Both of these lesions can contribute to recurrent instability of the shoulder and require surgery to be treated. Currently, the most common procedures to address Hill-Sachs lesions are the remplissage procedure (transfer of the infraspinatus into the posterior humeral head defect), capsular shift, disimpaction technique, humeral head resurfacing, bone block transfer, or shoulder arthroplasty. Reverse Hill-Sachs lesions are managed with similar procedures, such as the remplissage-equivalent technique described by McLaughlin, which involves transfer of the subscapularis tendon to fill the humeral head defect. The procedure has the advantage of "exteriorizing" the humeral head defect, but in the case of large lesions, it can result in significant loss of the articulating articular surface. The purpose of this article is to describe an arthroscopically assisted disimpaction technique with supplemental grafting using a balloon osteoplasty technique for a reverse Hill-Sachs lesion with bone cement to support and maintain the reduction.

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“…In a first step the reverse Hill-Sachs lesion was reduced using an inflatable balloon as used in kyphoplasty. In contrast to our experimental set-up [ 6 ] were we had a fenestrated cannula as a stearing instrument, we used two 1.6 mm K-wires as a sort of counter bearing/ abutment [ 18 ]. The K-wires were inserted parallel to the impressed reverse Hill-Sachs lesion not perforating the contralateral cortical bone (see Fig.…”

Section: Case Presentationmentioning

confidence: 99%

Balloon-guided inflation osteoplasty in the treatment of Hill-Sachs lesions of the humeral head: case report of a new technique

et al. 2016

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BackgroundThe use of the extra-vertebral balloon osteoplasty is increasing and in the meanwhile it has become a safe surgical technique in the treatment of tibial head, distal radius and calcaneus fractures. In addition, we already could show in a biomechanical setup that the balloon osteoplasty might be a safe tool for reduction in the treatment of Hill-Sachs lesions, but clinical application has not been performed so far.Case presentationWe report the case of a 53 year- old male patient who was referred to our Trauma department (level I trauma center) after the first manifestation of a posterior shoulder dislocation due to an epileptic seizure, originated in a- up to this date unknown -glioblastoma. After closed reduction of the dislocated shoulder the X-ray showed a subcapital fracture of the proximal humerus with a large reversed Hill-Sachs lesion. We performed an open surgery via a deltoideopectoral approach and balloon osteoplasty was used to reduce the impression fracture (Hill-Sachs lesion) before fixing the fracture with a locking plate. In the post-operative CT scan we could show an anatomical reduction of the Hill-Sachs lesion. At the follow-up examination one year after surgery the patient reached full range of motion and stated no re-dislocation of the shoulder nor instability or pain.ConclusionThe reduction of an impressed humeral head fracture by use of balloon osteoplasty is a safe technique. This technique could be a new option in the treatment of Hill-Sachs lesions and might be an alternative to well known standard procedures like the remplissage or tendon transfers without affecting rotation.

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Balloon treatment of posterior shoulder dislocation with reverse Hill–Sachs injury: description of a new technique

Abstract: Based on this small series, we believe that this technique should be added to our current armamentarium for posterior shoulder dislocations showing a deep impaction fracture of the humeral head that are at risk for recurrent dislocation.

Cited by 15 publications

References 19 publications

Locked posterior dislocation of the shoulder

Locked posterior dislocation of the shoulder

Arthroscopic Reduction and Balloon Humeroplasty in the Treatment of Acute Hill-Sachs Lesions

Balloon-guided inflation osteoplasty in the treatment of Hill-Sachs lesions of the humeral head: case report of a new technique

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