A MODIFICATION OF THE McLAUGHLIN PROCEDURE AS SALVAGE FOR MISSED LOCKED POSTERIOR FRACTURE-DISLOCATION OF THE HUMERAL HEAD

Dervin, Geoffrey F.; Brunet, Jean-Baptiste; Healey, David C.

doi:10.2106/00004623-200205000-00018

Cited by 16 publications

(14 citation statements)

References 16 publications

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“…Finally, Dervin describes a case of a missed traumatic posterior fracture dislocation presenting after 3 months and treated with the McLaughlin procedure. The patient returned to work after 12 weeks with active forward flexion of 150°, external rotation of 30°, and internal rotation of T12 [2].…”

Section: Discussionmentioning

confidence: 99%

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Successful Treatment of Chronic, Locked Posterior Shoulder Dislocations in Young Trauma Patients with the Modified McLaughlin Procedure

2006

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European Journal of Trauma Ab stractThe objective of this study was to examine the functional outcome of the Neer and Hawkins modification of the McLaughlin procedure for chronic, locked posterior dislocations of the shoulder in young patients. A retrospective chart analysis was performed on six patients treated by a single orthopedic surgeon over an 11-year period. Complete medical records were available for four patients who were the subjects of this study. Each patient underwent a transfer of the lesser tuberosity into the anteromedial head defect (modified McLaughlin procedure), with subsequent immobilization and physical therapy. One patient required a staged rotational osteotomy with internal fixation 2 weeks after the index procedure. The mean age of the patients was 29.75 (range, 20-44), while the mean follow-up period was 12.5 months (range, 9-19 months). There was an average increase in abduction of 47°, an increase in forward flexion of 49°, an increase in external rotation of 23°, and an increase in internal rotation of 19°, when comparing the pre-and postoperative range of motion. Total UCLA scores post-operatively averaged 25.3 (range, 21-29) out of 35. All shoulders were stable without any episodes of redislocation at follow-up. This study supports the use of the Neer and Hawkins modification of the McLaughlin procedure in young patients with a chronic, locked posterior dislocation of the shoulder.

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Section: Discussionmentioning

confidence: 99%

“…The tuberosity fragment is placed into the humeral head defect with guide pins as provisional fixation. Guidewires are dislocations of the shoulder in young trauma patients [1][2][3][4]. Robinson and Aderinto [5] noted that lower functional outcomes are expected when the dislocation was diagnosed "late" and the humeral defect was large.…”

Section: Techniquementioning

confidence: 99%

Successful Treatment of Chronic, Locked Posterior Shoulder Dislocations in Young Trauma Patients with the Modified McLaughlin Procedure

2006

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“…Continued forceful contraction pushes the internally rotated humeral head into the posterior aspect of the glenoid causing a compression fracture (reversed Hill-Sachs lesion). 9 Avulsion fractures of muscular origins lead to greater and lesser tuberosity fractures and pull of the strong adductors against deltoid and supraspinatus leads to fractures of the humeral neck. In a study of 73 posterior fracturedislocations in 66 patients, only 3 were found to be four-part fractures.…”

Section: Discussionmentioning

confidence: 99%

Bilateral posterior four-part fracture–dislocations of the shoulders following electric shock

Cooke

Hackney

2005

Injury Extra

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“…The current, recommended procedure of treatment of reverse Hill-Sachs lesion is modified McLaughlin's technique [8,9]. McLaughlin, in 1952 [10], described a procedure involving transferring subscapularis tendon into the depths of the defect in the humerus and fixing it by means of mattress sutures passed through holes drilled in the bone.…”

Section: Discussionmentioning

confidence: 99%

Traumatic Bilateral Posterior Fracture-Dislocation of Shoulders

Jayanthi¹,

Logan²,

Wootton

2004

Eur J Trauma

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European Journal of Trauma Ab stractBilateral posterior fracture-dislocation of shoulders (BPFDS) is a rare injury and is most commonly sustained after epileptic seizure, extreme trauma or electrocution. A unique case of isolated BPFDS as a result of a fall from a bicycle in a healthy young man is presented. Unilateral posterior fracture-dislocation of the shoulder as a result of trauma is rare and such an injury occurring bilaterally is yet to be reported in the literature. BPFDS is associated with rotator cuff tears, reverse Hill-Sachs lesion and posterior labrum injuries. BPFDS if not treated promptly can lead to avascular necrosis of the head of humerus. Diagnosis of BPFDS is difficult and if there is any suspicion on the plain films, CT or MRI scans should be performed to confirm the diagnosis and define any associated injuries. Case StudyA 34-year-old man presented to Accident & Emergency after falling from his bicycle whilst traveling downhill, practicing for a race. The exact mechanism of the fall and the position on landing cannot be remembered despite having remained conscious throughout. After the accident, the patient managed to carry his bike to the road. The only symptom that the patient complained of was severe pain in both shoulders. He was otherwise fit and well with no past medical history of epilepsy or previous shoulder injury. On examination, the normal contours of both shoulders were lost and the arms were held adducted. He was unable to move either arm at the shoulder because of pain. Neurologic examination demonstrated the axillary nerves and all other branches of the brachial plexus to be intact. A full secondary survey did not reveal any other injuries. Anteroposterior (AP) X-ray of the right shoulder ( Figure 1a) showed an undisplaced fracture of the surgical neck of humerus extending into the metaphysis distally, and the axillary view (Figure 1b) demonstrated posterior dislocation of the humeral head. AP view of left shoulder (Figure 2a) showed deformity of the humeral head, whereas the axillary view (Figure 2b) demonstrated posterior dislocation of the shoulder with a displaced surgical neck and metaphyseal humeral fracture.His right shoulder was manipulated under anesthesia ( Figure 3). The shoulder was found to be stable on screening and hence no further intervention was performed. However, his left shoulder was found to be particularly unstable and hence the injury was treated with an open reduction and cancellous screw fixation ( Figure 4). Postoperatively, his right shoulder was immobilized in a full-arm plaster held in slight abduction and external rotation attached to a thoracoabdominal spica. The left shoulder was supported in a collar and cuff.There were no immediate postoperative complications and the patient went on to complete a full course of physiotherapy. At 3-month outpatient follow-up, he had full range of movement in the right shoulder, and some restriction of abduction and external rotation in the left shoulder. At 9-month follow-up, the left shoulder had regained ...

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A MODIFICATION OF THE McLAUGHLIN PROCEDURE AS SALVAGE FOR MISSED LOCKED POSTERIOR FRACTURE-DISLOCATION OF THE HUMERAL HEAD

Cited by 16 publications

References 16 publications

Successful Treatment of Chronic, Locked Posterior Shoulder Dislocations in Young Trauma Patients with the Modified McLaughlin Procedure

Successful Treatment of Chronic, Locked Posterior Shoulder Dislocations in Young Trauma Patients with the Modified McLaughlin Procedure

Bilateral posterior four-part fracture–dislocations of the shoulders following electric shock

Traumatic Bilateral Posterior Fracture-Dislocation of Shoulders

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