Bilateral neglected posterior dislocation of the shoulder treated by reverse arthroplasty and contralateral osteochondral autograft. A case report

Zanini, Beatrice; Rusconi, Mattia; Fornara, Paolo; Grassi, Federico Alberto

doi:10.1016/j.tcr.2021.100455

Cited by 3 publications

(2 citation statements)

References 11 publications

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“…Of the seven included articles, one assessed only TSA outcomes; one assessed only HSA outcomes; two reported TSA and HSA outcomes, separated by intervention type; and three studies combined data from TSA and HSA, not separating outcome data by intervention type. Table 2 reports nine case studies for operative outcomes following shoulder arthroplasty for locked dislocation 20,25–32 . Among these case studies, a total of 20 operative outcomes were included.…”

Section: Resultsmentioning

confidence: 99%

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Systematic Review and Meta‐Analysis of Locked Posterior Dislocation of the Shoulder Treated with Shoulder Arthroplasty: Improved Outcomes for Total Shoulder Arthroplasty are Associated with Increased Age

Crowley

Ghattas

Collins

et al. 2023

Orthopaedic Surgery

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Locked shoulder dislocations account for up to 5% of shoulder dislocations. These relatively rare injuries are characterized by dislocation of the humeral head from the scapular glenoid cavity with the humeral head incarcerated on the glenoid in a "locked" fashion. Diagnosis is often delayed because of the complexity of clinical presentation and subtle radiographic findings, resulting in locking of the humeral head out of the glenoid cavity with severe functional deficits. Most commonly, there are bony injuries to the glenoid and humeral head that engage and prevent closed reduction. Since few patients present with this injury, evidence-based treatment guidelines have not been established. The objective of this review is to assess postoperative outcomes following shoulder arthroplasty for locked posterior shoulder dislocations (LPSD) to guide best practices for treatment. This systematic review was conducted following PRISMA guidelines, searching the PubMed and Web of Science databases for original articles assessing outcomes following arthroplasty for locked posterior shoulder dislocations. Seven publications that evaluated 102 patients were included. Additionally, nine case studies were included, assessing 20 shoulder arthroplasties. Overall, the analysis demonstrated significant improvement in shoulder pain following total shoulder arthroplasty (TSA) (P = 0.0003). Older operative patient ages for TSA resulted in significantly improved modified Neer outcomes scores and patient satisfaction compared to younger patients (P = 0.047). A positive correlation was noted for the duration of dislocation and necessity for revision surgery following hemiarthroplasty (HSA) and TSA combined and TSA separately. The risk ratios assessing the incidence of postoperative complications (RR = 0.56, 95% CI = 0.28-1.11) and necessity for revision surgery (RR = 0.58, 95% CI = 0.24-1.39) were insignificant but noted outcomes favoring TSA. Data from the included studies show that both TSA and HSA are efficacious at treating locked posterior shoulder dislocation. Postoperative outcomes following TSA versus HSA are similar. TSA may be a more efficacious surgical treatment in elderly patients, with improved outcomes and patient satisfaction scores compared to younger patients. Early diagnosis and treatment of posterior locked dislocations may lead to reduced postoperative complications and revision surgery, signaling the importance of proper injury investigation and early treatment. The role of RSA in the management of locked posterior shoulder dislocation remains to be determined, as there is insufficient clinical outcome data currently in the literature.

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Section: Resultsmentioning

confidence: 99%

“…Table 2 reports nine case studies for operative outcomes following shoulder arthroplasty for locked dislocation. 20 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 Among these case studies, a total of 20 operative outcomes were included. Of these, two patients underwent TSA, 10 RSA, and eight HSA.…”

Section: Resultsmentioning

confidence: 99%

Systematic Review and Meta‐Analysis of Locked Posterior Dislocation of the Shoulder Treated with Shoulder Arthroplasty: Improved Outcomes for Total Shoulder Arthroplasty are Associated with Increased Age

Crowley

Ghattas

Collins

et al. 2023

Orthopaedic Surgery

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Bilateral Locked Posterior Fracture-Dislocation of the Shoulder After Epileptic Seizures Secondary to Cavernous Hemangioma: A Case Report and Literature Review

Pangopoulos,

Papagiannis,

Koutas

et al. 2023

Am J Case Rep

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Patient: Male, 57-year-old Final Diagnosis: Bilateral locked posterior shoulder dislocation Symptoms: Shoulder pain Clinical Procedure: — Specialty: Neurosurgery • Orthopedics and Traumatology Objective: Rare disease Background: Posterior shoulder dislocation is an uncommon injury, accounting for less than 5% of all glenohumeral dislocations. Bilateral locked posterior shoulder fracture-dislocation is an extremely rare entity with an incidence of 0.6 cases/100 000 people/year. A few reports have been published in the literature, predominantly associated with epileptic seizures. Case Report: We present a rare case of a 55-year-old male patient with a history of epileptic seizures, who presented with bilateral, locked, posterior fracture-dislocation of the shoulder following an epileptic seizure. The patient was diagnosed with a cavernous hemangioma, which caused his epileptic episode. He was treated operatively, with a modified McLaughlin procedure performed on both sides, at 1 stage, by 2 surgical teams. The cavernous hemangioma was also resected 2 months later. After a follow-up period of 18 months, no recurrent episodes of instability or dislocation were identified. Full range of motion was present on both sides, with good clinical and radiological outcomes. We also conducted a literature review to elucidate the causes of this rare incidence, along with diagnostic workup and treatment options. We were able to identify 36 cases, involving 72 shoulders of bilateral posterior fracture-dislocations in 30 case reports and 2 case series. Conclusions: Bilateral posterior fracture-dislocation of the shoulder is uncommon. Treatment strategy depends on the chronicity, involvement of the humeral head, and the patient’s age and functional level. The target is to restore shoulder anatomy and maintain a functional range of motion.

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Luxación posterior bilateral traumática de hombro: reporte de un caso

Concha,

Calvache,

Palechor

et al. 2024

Rev. colomb. ortop traumatol.

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Introducción. La luxación traumática posterior de hombro es una lesión rara; además, su ocurrencia bilateral es aún menos frecuente y se asocia a convulsiones o electrochoques. Presentación del caso. Hombre de 25 años que fue atendido en el Servicio de Urgencias de un hospital de segundo nivel de atención de Popayán (Colombia) luego de chocar en una motocicleta contra un automóvil. Con base en los signos clínicos y los hallazgos en las radiografías y la tomografía axial computarizada, se confirmó el diagnóstico de luxación posterior de hombro bilateral, por lo que se realizó reducción cerrada. La rehabilitación se inició a la tercera semana del procedimiento y se realizó seguimiento mensual de la funcionalidad de los hombros utilizando la escala Disabilities of the Arm, Shoulder and Hand (DASH) abreviada. La recuperación fue satisfactoria y, al año de seguimiento, no presentó ninguna limitación funcional ni cambios radiográficos sugestivos de artrosis o necrosis ósea. Conclusión. La luxación posterior traumática de hombro es una condición poco frecuente y usualmente pasada por alto, por lo que debe tenerse en cuenta como diagnóstico diferencial en pacientes con trauma de hombro, con el fin de realizar un tratamiento oportuno y evitar secuelas funcionales graves.

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Bilateral neglected posterior dislocation of the shoulder treated by reverse arthroplasty and contralateral osteochondral autograft. A case report

Cited by 3 publications

References 11 publications

Systematic Review and Meta‐Analysis of Locked Posterior Dislocation of the Shoulder Treated with Shoulder Arthroplasty: Improved Outcomes for Total Shoulder Arthroplasty are Associated with Increased Age

Systematic Review and Meta‐Analysis of Locked Posterior Dislocation of the Shoulder Treated with Shoulder Arthroplasty: Improved Outcomes for Total Shoulder Arthroplasty are Associated with Increased Age

Bilateral Locked Posterior Fracture-Dislocation of the Shoulder After Epileptic Seizures Secondary to Cavernous Hemangioma: A Case Report and Literature Review

Luxación posterior bilateral traumática de hombro: reporte de un caso

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