Posterior fracture dislocation of the proximal humerus

Abstract

Background. Posterior dislocation fractures of the humerus occur as impression fractures of the humeral head (reverse Hill-Sachs fracture) and posteriorly dislocated proximal humeral (PH) fractures with a subcapital component. This study evaluated fracture patterns, current treatment, and revision rates. Methods. Data of patients who underwent surgical treatment for PH dislocation fractures in two level-I trauma centers between 2010 and 2018 were retrospectively reviewed. Results. We identified 41 shoulders in 37 patients (n = 12 female, n = 25 male; average age 52 [25-91] years) with open surgical treatment of PH posterior dislocation fractures. In 14 patients, the cause was convulsive seizure or electrical accident, in 23 patients, a fall or high-energy trauma.

Promising Mid-Term Outcomes after Humeral Head Preserving Surgery of Posterior Fracture Dislocations of the Proximal Humerus

“…The range of surgical possibilities emphasizes the complexity of this injury [8]. High-velocity trauma and epileptic seizures have been reported as major causes of PFDs [9][10][11].…”

“…Operative approaches include open reduction and internal fixation, defectfilling (allo-and/or autograft; mod. McLaughlin procedure), hemi-arthroplasty, and primary (reverse) total arthroplasty [8][9][10][11]. Because of the rare incidence and the broad spectrum of therapeutic approaches regarding PFD, there is a small number of clinical studies in the literature, mainly focusing on primary arthroplasty [6,12], and while those studies report acceptable to good outcome parameters with hemi-arthroplasty and primary reverse arthroplasty, there is a lack of clinical outcome studies focusing on treatments that would preserve the humeral head instead of replacing it.…”