Arthroscopic Reduction of a Chronic Locked Posterior Shoulder Dislocation

Abstract

Posterior shoulder dislocation is a rare condition. It is easily overlooked and often appears in a chronic locked status, which makes the reduction difficult, even through open procedures. Few reports in the literature have described an isolated arthroscopic reduction because it is difficult to elevate the humeral head to the level of the glenoid surface and obtain anterior-posterior soft-tissue balance. On the basis of an analysis of the mechanisms of the locking of the humeral head and the soft-tissue imbalance, we describe a set of arthroscopic shoulder release and reduction techniques, which include mainly the removal of rotator interval tissue; a thorough subscapularis release from the coracoid, the conjoined tendon, and the glenoid; and a 360° capsule-muscle release from the glenoid and the scapula. The described technique is an effective method to obtain a medial-to-lateral humeral head reduction and anterior-to-posterior soft-tissue balance. The introduction of this technique will provide a practical tool for surgeons to realize an arthroscopic shoulder reduction in the case of a chronic locked posterior shoulder dislocation.

Arthroscopic Reduction of a Missed/Neglected Anterior Shoulder Dislocation and Concomitant Repair of the Rotator Cuff Tendon

“…Arthroscopic approach for reduction of a locked posterior dislocation has been described in a recent report. 10 The present technique for arthroscopic reduction of anterior dislocation is less time-consuming than an open approach. It also avoids extensive dissections of the deltoid muscle, thus avoiding severe postoperative pain, a prolonged rest period for deltoid healing, and a lengthy rehabilitation period.…”

All-Arthroscopic Management of Locked Posterior Shoulder Dislocation: Reduction Under Direct Visualization and Treatment of Intra-articular Pathologies

“…When treating PSD and reducing shoulder injuries, arthroscopic 10 is preferred over open 17 procedures due to their minimally invasive approach and the ability to visualize the articular surface and the posterior capsulolabral junction. This allows for better centering of the humeral head through direct visualization.…”

“…This can decrease the presence of fibrous tissue and lower the risk of iatrogenic fractures during reduction maneuvers. 7 , 8 , 9 , 10 …”