Management and Prognostic Factors for Delayed Reconstruction of Neglected Posterior Shoulder Fracture-Dislocation

Bekmezci, Taner; Altan, Egemen

doi:10.5812/atr.29903

Cited by 3 publications

(4 citation statements)

References 14 publications

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“…While our study has the major limit of a small sample, we could assume that our excellent results depend on an early diagnosis. Other series reported in the literature showed how a posterior GHJ dislocation with an associated bone fracture [32], or a reverse Hill-Sachs lesion lower than 50% [33], could be treated with a treatment within 5 months. However, there is also evidence of good results with a later diagnosis with a great functional improvement.…”

Section: Discussionmentioning

confidence: 98%

Surgical and Rehabilitative Treatment of Misdiagnosed Posterior Dislocation of the Shoulder: Case Series

Pavone

Caruso

Chisari

et al. 2018

JFMK

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Abstract:Background: Posterior gleno-humeral joint (GHJ) dislocation is a rare injury accounting for 2.7-3% of all shoulder dislocations. Early detection is the key for an effective treatment. Poor clinical outcomes or prosthetic solutions depend on the severity of the lesions at the time of trauma and worsening of the McLaughlin lesion during the months when the dislocation remains unrecognized or untreated. The aim of the study is to report our experience in treating, and clinically and radiographically evaluate the outcomes of, four neglected posterior GHJ dislocations. Methods: Four patients with inveterate posterior dislocation of the shoulder were evaluated. In three cases, the technique of McLaughlin was performed, and in one case, plication of the subscapularis tendon was performed. During the follow up, patients were clinically evaluated using the Constant shoulder score; an imaging investigation, using X-ray integrated with computed tomography(CT) and magnetic resonance imaging (MRI), was assessed. Results: Following the Constant criteria, treated shoulders reported an excellent outcome with an average score of 91. The mean score of untreated shoulders was 92.5. The humeral appearance that resulted was radiographically well-structured. Surgical treatment with McLaughlin lesion or transposition of the subscapularis were satisfactory from a subjective and objective point of view. To perform surgery soon as possible after the traumatic episode is considered a positive prognostic factor.

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Section: Discussionmentioning

confidence: 98%

Surgical and Rehabilitative Treatment of Misdiagnosed Posterior Dislocation of the Shoulder: Case Series

Pavone

Caruso

Chisari

et al. 2018

JFMK

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“…Unfortunately, it is difficult to easily interpret the literature data relating to the results obtained with surgical treatment because the various series are each made up of few cases and the patients included in the studies have often different initial anatomopathological pictures. Furthermore, the uncertainty is amplified by the fact that there is no uniformity of thought regarding: (1) how to treat the posterior fracture dislocation and, consequently, which type of surgical approach has to be used (deltopectoral [3,16,[23][24][25][26][28][29][30]32,36,37,47], deltoid splitting [35], superior subacromial [4], vertical posterior [4,13,31], horizontal posterior [39], combined anterior and posterior [4,11,14], axillary [9] approach); (2) how to relocate the humeral head into the glenoid fossa (manually or by means surgical instruments that could cause further cartilage damage); and (3) how to fix the fracture dislocation (sutures, plates, K wires, screws) when the hypothesis of a prosthesis implant is not considered.…”

Section: Discussionmentioning

confidence: 99%

“…In the Wronka et al [2] series, consisting of 104 cases of fracture dislocation of the shoulder joint, only 10 cases were posterior (9.6%). Posterior fracture dislocation predominantly occurs in males aged between 35 to 55 years [1,[3][4][5][6][7][8]; these injuries frequently occur as a consequence of seizure [4,5,[9][10][11][12]; fall from height [1,4,7,9,13]; motor-vehicle accidents [4,5,7,13,14], or as a result of electrocution [4,15,16]. In a cohort of 164 patients with posterior fracture dislocation belonging to five different series [17][18][19][20][21], 24 (14%) had a bilateral posterior fracture dislocation.…”

Section: Introductionmentioning

confidence: 99%

“…Because of the rarity of this nosological entity and of different osteocartilaginous and capsololigamentous injuries that can be associated with posterior fracture dislocation, there is no uniformity of thought in the literature regarding how to manage it. In fact, a vast array of conservative or surgical treatments have been proposed: reduction of the dislocation and conservative treatment [2,5,22]; reduction and osteosuture [23]; reduction and anatomical reconstruction for reverse Hill Sachs lesion with bone graft [24,25]; classical or modified McLaughlin procedure [10,[26][27][28][29]; reduction and synthesis with Kirschner/Steinmann wires [3,9,30,31] or with free screws [1,5,16,32]; reduction and synthesis with plate and screws [1,3,6,11,14,[33][34][35][36]; humeral surface replacement [37]; hemiarthroplasty [2,6,10,15,31,33,38]; or arthroplasty [39].…”

Section: Introductionmentioning

confidence: 99%

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Humeral Head Three-Part Posterior Fracture-Dislocation Reduced through a Posterior Approach and Fixed with Blocked Threaded Wires: A Consecutive Case Series

Gumina

Candela

2023

Medicina

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Background and Objectives: Posterior fracture dislocations are rare. There is currently no uniformity regarding treatment. Therefore, outcomes are difficult to compare. We evaluated clinical and radiological outcomes of patients with humeral head posterior fracture dislocation treated with an open posterior reduction and then fixed with a biomechanically validated configuration of blocked threaded wires. Materials and Methods: 11 consecutive patients with humeral head three-part posterior fracture dislocation were treated by reduction through a posterior approach and fixed with blocked threaded wires. All patients were clinically and radiographically evaluated after a mean follow-up of 50 months. Results: The mean irCS was 86.1% (range: 70.5–95.3%). No significant difference was found between irCS at 6 and 12 months postoperatively and the final follow-up. Six patients noted their pain intensity as 0/10, three as 1/10, and two as 2/10. The postoperative reduction was considered as excellent in eight patients (Bahr’s criteria) and good in the remaining three; at the final follow-up, reduction was excellent and good in seven and four patients, respectively. The mean neck-shaft angles at FU 0 and at the final FU were 137° and 132°, respectively. No signs of avascular necrosis, non-union, and arthritis progression were seen. No recurrence of dislocation or posterior instability symptoms were reported. Conclusions: We believe that our very satisfactory results stem from: (1) the manual reduction of the dislocation through a vertical posterior surgical approach, which does not produce further osteocartilaginous damage of the humeral head; (2) no multiple perforations of the humeral head are performed; (3) the threaded wires have a smaller diameter than the screws, therefore they preserve the bone tissue of the humeral head; (4) deperiostization or further detachment of soft tissues are not expected; (5) the adopted and validated system is stable and limits translation, torsion, and the collapse of the humeral head.

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Locked posterior dislocation of the shoulder

2018

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Locked posterior dislocation of the shoulder is very rare. Seizures and trauma are the most common causes of this injury.There is no current benchmark treatment strategy for these rare cases.This study has shown that reconstruction of the shoulder joint in an anatomical way in acute and chronic cases up to 16 weeks provides good results.The purpose of this study is to evaluate the results of different treatment procedures with outcomes and to compare the results of the same procedures in acute and chronic cases.Cite this article: EFORT Open Rev 2017;3:15–23. DOI: 10.1302/2058-5241.3.160089.

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Management and Prognostic Factors for Delayed Reconstruction of Neglected Posterior Shoulder Fracture-Dislocation

Cited by 3 publications

References 14 publications

Surgical and Rehabilitative Treatment of Misdiagnosed Posterior Dislocation of the Shoulder: Case Series

Surgical and Rehabilitative Treatment of Misdiagnosed Posterior Dislocation of the Shoulder: Case Series

Humeral Head Three-Part Posterior Fracture-Dislocation Reduced through a Posterior Approach and Fixed with Blocked Threaded Wires: A Consecutive Case Series

Locked posterior dislocation of the shoulder

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