Complex Posterior Fracture-Dislocation of the Shoulder

Robinson, C. M.; Akhtar, Adeel; Mitchell, Michael; Beavis, Cole

doi:10.2106/jbjs.f.01214

Cited by 84 publications

(66 citation statements)

References 50 publications

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“…Robinson separated posterior dislocations to simple dislocations and fracture-dislocations with a concomitant displaced fracture of the humeral head typically at the anatomical neck [12,13]. The 24 patients in that study underwent surgery within an average of 14 hours after referral with open reduction and internal fixation.…”

Section: Discussionmentioning

confidence: 99%

Chronic locked posterior shoulder dislocation with severe head involvement

Gavriilidis¹,

Magosch²,

Lichtenberg³

et al. 2009

International Orthopaedics (SICOT)

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Arthroplasty is the treatment of choice for severely damaged humeral heads in chronic locked posterior dislocation of the shoulder. We retrospectively reviewed the results of 12 shoulder arthroplasties (11 patients) between 1999 and 2005. Mean follow-up was 37.4±16.8 months. Mean postoperative Constant score (CS) was 59.4±21.6 (normative age and gender-related CS 67.1±24). There was a significant improvement in range of motion for flexion, abduction and external rotation. There was negative correlation (Pearson's coefficient) between the related CS and number of previous operations, pain and duration of symptoms. One patient underwent revision surgery 36 months postoperatively with polyethylene insert exchange. There were two patients with mild and one with severe migration of the humeral head. Shoulder arthroplasty resulted in good midterm results for this patient group with benefits for range of motion, pain and patient satisfaction.

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Section: Discussionmentioning

confidence: 99%

Chronic locked posterior shoulder dislocation with severe head involvement

Gavriilidis¹,

Magosch²,

Lichtenberg³

et al. 2009

International Orthopaedics (SICOT)

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show abstract

“…In PSD with the rarer complex fractures of the proximal aspect of the humerus, there have been favourable functional results with the use of open relocation, fracture reduction and stabilisation, and adjuvant stabilisation procedure if necessary in 28 cases. [8] In these complex fracture-dislocations, the majority of the functional loss in the long-term was attributable to loss of internal rotation of the shoulder.…”

Section: Discussionmentioning

confidence: 99%

Frozen shoulder or missed posterior dislocation?

Leijnen¹

2016

S Afr J SM

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The clinical presentation of a missed posterior shoulder dislocation has similarities with an idiopathic frozen shoulder masking proper diagnosis at the time of injury. We report a case of a 48-year-old woman with shoulder pain which demonstrates the importance of correct initial diagnosis and management. The glenohumeral (GH) joint consists of the humeral head that articulates in the glenoid fossa of the scapula, surrounded by several static and dynamic structures. It is the most mobile joint of the human body which makes it vulnerable to dislocation in all directions. Posterior shoulder dislocation (PSD) is less common than anterior. The rarity of this pathology together with the restrictions of standard view X-rays often leads to the diagnosis being missed. Case reportA 48-year-old woman presented with 4 months of spontaneous progressive pain and limited range of motion of the right shoulder. Her pain was aggravated by movement and impacts, particularly those activities associated with daily living. She was unable to lie on her right side but did not complain of any pain at night. She had no history of trauma although she recently started experiencing episodes of syncope. Further to this, her medical history consisted of hypertension, hypercholesterolaemia, asthma and previous left frozen shoulder.Upon clinical examination she held the right upper limb in internal rotation with the elbow in flexed position. There was diffuse, mild tenderness over the anterolateral side of the shoulder. Range of motion was limited to 5 degrees of passive and active abduction. External rotation was not possible. Other shoulder tests were impossible to implement. X-rays showed normal proportions of the GH joint with the humeral head articulating in the glenoid. On the anterior side of the humeral head a medium sized dent was visible, suggestive of a reverse Hill-Sachs lesion. The differential diagnosis was an overlooked posterior shoulder dislocation or adhesive capsulitis.

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“…Wu et al, [13] in his series of 63 patients found no statistically significant difference in clinical, radiographic, and electrophysiological outcomes between the deltopectoral approach and deltoid-splitting approach while surgical treatment of proximal humeral fractures. Hepp et al, [14] in his study observed better functional results with deltopectoral approach and concluded that choice of approach affects the functional outcome in management of proximal humeral fractures. [15] However, Isiklar et al, [16] in his study observed better radiological and functional outcome with deltoid-splitting approach and recommended deltoid-splitting approach in management of AO (Arbeitsgmeinschaft fur Osteosynthesefragen) types B and C proximal humeral fractures.…”

Section: Fig 1 Deltopectoral Approach Fig 2 Deltoid Split Lateral Appmentioning

confidence: 93%

Comparison of deltoid-splitting approach versus deltopectoral approach for the management of proximal humeral fractures with Philos plate

ragavanandam¹

2016

IOSR

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Complex Posterior Fracture-Dislocation of the Shoulder

Cited by 84 publications

References 50 publications

Chronic locked posterior shoulder dislocation with severe head involvement

Chronic locked posterior shoulder dislocation with severe head involvement

Frozen shoulder or missed posterior dislocation?

Comparison of deltoid-splitting approach versus deltopectoral approach for the management of proximal humeral fractures with Philos plate

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