Arthroscopic Management of Locked Posterior Shoulder Dislocations

Abstract

Locked posterior shoulder dislocations occur relatively uncommonly but pose aunique array of challenges for the treating surgeon. Posterior labral detachments and capsular damage along with reverse Hill-Sachs lesions are commonly present in these patients and must often be addressed at the time of surgical intervention. Multiple open and arthroscopic procedures that address these pathologic lesions have been described. Arthroscopic shoulder stabilization for patients with locked posterior shoulder dislocations for whom significant posterior instability and subluxation persist following closed reduction is described. A specific patient who underwent both arthroscopic posterior stabilization and supplemental advancement of the subscapularis into the reverse Hill-Sachs defect serves as a case example of this technique.

Posterior Shoulder Dislocation with Engaging Reverse Hill–Sachs Lesion: A Retrospective Study of Ten Patients Treated with Arthroscopy or Open Reduction and Stabilization

“…Indeed, in 60% to 80% of the cases, posterior dislocations of the shoulder are not diagnosed at the first clinical examination as the patients’ pain does not allow joint mobilization and the axial view, which could be diagnostic, cannot be taken. Therefore, it is recommended to perform the Y-scapular view that provides information about the position of the humeral head and the severity of the reverse Hill–Sachs lesion: the humeral head can be clearly seen posterior to the glenoid and the Hill–Sachs lesion, which is typically seen in the anteromedial part of the humeral head, can also be studied [ 7 ].…”