Locked fracture dislocations of the proximal humerus: postoperative results and a proposed modification of the classification

Schmalzl, Jonas; Graf, Annika; Gilbert, Fabian; Kimmeyer, Michael; Gerhardt, Christian; Lehmann, Lars

doi:10.1007/s00590-021-03022-z

Cited by 8 publications

(14 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…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%

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

View full text Add to dashboard Cite

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.

show abstract

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

View full text Add to dashboard Cite

show abstract

“…Locked fracture-dislocation of the proximal humerus (LFDPH) is a very rare but more severe complex injury. In this type of injury, fractures often occur in the surgical neck, and the humeral head is completely disengaged from the humeral shaft and displaced and locked onto the glenoid rim [ [3] , [4] , [5] , [6] , [7] ]. LFDPH is most often caused by a high-energy axial loading force with the arm adducted, flexed, and internally rotated; thus, the majority of these injuries occur in young patients [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Assessment of surgical management for locked fracture-dislocations of the proximal humerus in patients of different ages

Feng,

Jiang,

Kang

et al. 2023

Heliyon

View full text Add to dashboard Cite

“…For addressing the defect at the anterior part of the humeral head, a variety of surgical procedures exist: (a) filling the defect by subscapularis tendon transposition [ 5 ], (b) medial transposition of the lesser tuberosity [ 6 , 7 ], (c) defect-filling with allograft [ 8 ], (d) rotational osteotomy [ 9 ], (e) arthroplasty [ 10 , 11 ], and (f) arthroscopic or open elevation and stabilization of the impression fracture [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Posterior shoulder dislocation with associated reverse Hill–Sachs lesion: clinical outcome 10 years after joint-preserving surgery

Konrads

Döbele

et al. 2022

Arch Orthop Trauma Surg

View full text Add to dashboard Cite

Introduction Posterior shoulder dislocation in association with reverse Hill–Sachs lesion is a rather rare injury. Few studies reporting results after joint-preserving surgery in these cases are available. This current study presents the clinical outcomes 10 years postoperatively. Materials and methods In a prospective case series, we operatively treated 12 consecutive patients (all males) after posterior shoulder dislocation with associated reverse Hill–Sachs lesion using joint-preserving techniques. Patients received surgery in a single center between January 2008 and December 2011. The joint-preserving surgical procedure was chosen depending on the defect size and bone quality. The following outcome-measures were analyzed: Constant-Score, DASH-Score, ROWE-Score, and SF-12. Results 1, 5, and 10 years postoperatively were compared. Results Out of 12 patients, ten patients (83.3%) were followed-up with a mean follow-up interval of 10.7 years (range 9.3–12.8). The mean patient age at the time of the last follow-up was 51 years (32–66). The outcome scores at the final follow-up were: Constant 92.5 (range 70.0–100), DASH 3.2 (0.0–10.8), ROWE 91.0 (85.0–100), and SF-12 87.8 (77.5–98.3). Clinical results had improved from 1 to 5 years postoperatively and showed a tendency for even further improvement after 10 years. Conclusions Joint-preserving surgical therapy of posterior shoulder dislocation provides excellent results when the morphology of the reverse Hill–Sachs lesion is respected in surgical decision-making. Trial registration 223/2012BO2, 02 August 2010.

show abstract

Locked fracture dislocations of the proximal humerus: postoperative results and a proposed modification of the classification

Cited by 8 publications

References 16 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

Assessment of surgical management for locked fracture-dislocations of the proximal humerus in patients of different ages

Posterior shoulder dislocation with associated reverse Hill–Sachs lesion: clinical outcome 10 years after joint-preserving surgery

Contact Info

Product

Resources

About