Posterior shoulder dislocation with reverse Hill-Sachs lesion. A technical note and report of two cases

Abstract

Posterior shoulder dislocation (PSD) with a reverse Hill-Sachs lesion is a rare injury with challenging management. This article is a technical note, describing the combination of both, modified McLaughlin procedure with posterior Bankart repair, for the surgical treatment of traumatic PSD associated with a substantial reverse Hill-Sachs lesion. Two patients with mid-term follow-up are presented. Approaching and repairing both sides of the joint, balance and congruency are restored, the humeral head is centralized in the glenoid and the patient starts early mobilization and rehabilitation safely.

Bilateral locked posterior shoulder dislocation overlooked for 15 months treated with the modified McLaughlin procedure: A case report

“…[ 11 - 16 ] In addition, the literature review revealed that a significant number of neglected (late presenting or overlooked) patients, particularly those with reverse Hill-Sachs lesions between 20 and 45%, were treated with the modified McLaughlin procedure. [ 1 , 6 , 28 - 34 , 37 ]…”

“…[11][12][13][14][15][16] In addition, the literature review revealed that a significant number of neglected (late presenting or overlooked) patients, particularly those with reverse Hill-Sachs lesions between 20 and 45%, were treated with the modified McLaughlin procedure. [1,6,[28][29][30][31][32][33][34]37] Khira and Salama [28] reported the results (n=12) of an open reduction and reconstruction of the humeral head defect using the McLaughlin technique modified by Hawkins et al, [10] in which the insertion of the subscapularis muscle was displaced with lesser tuberosity and augmented with a bone graft from the iliac crest fixed with screws. In their study, the time between dislocation and diagnosis ranged from four weeks to three months, with a mean of eight weeks.…”

“…Modified McLaughlin surgery with or without open reduction and internal fixation (ORIF) and allograft/ autograft reconstruction produce favorable results in young patients and patients with adequate bone supply. [1,6,[28][29][30][31][32][33][34][35][36][37]39] Recently, arthroscopic reverse-remplissage techniques have been published in orthopedic journals, reporting successful results (with good follow-up). [17,18] However, despite these two successful reports, the author reports that the arthroscopic reverse-remplissage procedure requires a high degree of surgical skill and is associated with a long learning curve.…”