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Arthroscopically Assisted Reduction in a Chronic Locked Posterior Shoulder Dislocation.

ABSTRACT: Neglected posterior shoulder dislocation is a difficult condition in terms of decision making and surgical technique. Not only the bony deformity but also the soft tissue and patient's underlying disease are of concern. Whether the poor results are associated with a time delay or the treatment method is not clear yet. To date, there is neither a consensus nor treatment guidelines. We describe an arthroscopically assisted reduction and open McLaughlin procedure. The advantage of this procedure is preservation of the soft tissue of the anterior part of the shoulder during the surgical reduction technique for chronic neglected posterior shoulder dislocation cases.

SUBMITTER: Prasathaporn N

PROVIDER: S-EPMC6714613 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature

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Arthroscopically Assisted Reduction in a Chronic Locked Posterior Shoulder Dislocation.

Prasathaporn Niti N Laohathaimongkol Thongchai T Umprai Vantawat V Kuptniratsaikul Vanasiri V

Arthroscopy techniques 20190701 7

Neglected posterior shoulder dislocation is a difficult condition in terms of decision making and surgical technique. Not only the bony deformity but also the soft tissue and patient's underlying disease are of concern. Whether the poor results are associated with a time delay or the treatment method is not clear yet. To date, there is neither a consensus nor treatment guidelines. We describe an arthroscopically assisted reduction and open McLaughlin procedure. The advantage of this procedure is ...[more]

PMID: 31485405

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Arthroscopic Reduction of a Chronic Locked Posterior Shoulder Dislocation.

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Posterior Glenohumeral Capsular Reconstruction With Modified McLaughlin for Chronic Locked Posterior Dislocation.

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Arthroscopic Management of Locked Posterior Shoulder Dislocations.

Project description:Locked posterior shoulder dislocations occur relatively uncommonly but pose aunique array of challenges for the treating surgeon. Posterior labral detachments and capsular damage along with reverse Hill-Sachs lesions are commonly present in these patients and must often be addressed at the time of surgical intervention. Multiple open and arthroscopic procedures that address these pathologic lesions have been described. Arthroscopic shoulder stabilization for patients with locked posterior shoulder dislocations for whom significant posterior instability and subluxation persist following closed reduction is described. A specific patient who underwent both arthroscopic posterior stabilization and supplemental advancement of the subscapularis into the reverse Hill-Sachs defect serves as a case example of this technique.

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Chronic locked posterior gleno-humeral dislocation: technical note on fibular grafting for restoration of humeral head sphericity.

Project description:BackgroundReconstruction of reverse Hill-Sachs defect using osteo-chondral allograft has the advantages of spherical re-contouring and provision of smooth biological articular surface of the reconstructed humeral head. However, worldwide availability and risk of disease transmission of osteo-chondral allograft remain points of increasing concerns. As an alternative to lacking osteo-chondral allograft, the current technical note describes a reconstructive technique of reverse Hill-Sachs defect using autologous fibular grafting.MethodsFollowing open reduction of the dislocated humeral head, reverse Hill-Sachs defect was reconstructed using 3-4 autologous fibular pieces (each is of 10 mm in length) fixed in flush with the articular cartilage using 4-mm cancellous screws. Defect reconstruction was then followed by modified McLaughlin's transfer and posterior capsulorrhaphy.ResultsSpherical contour of the humeral head and gleno-humeral range of motion were restored. Intra-operative dynamic testing of the reconstruct revealed no residual posterior gleno-humeral instability.ConclusionCurrently reported technique might offer advantages of graft availability, technical simplicity, familiarity and reproducibility, safety (i.e. no disease transmission) and bone preservation facilitating future revision management (if needed). Nevertheless, long-term outcomes of this technique should be investigated via further cohort clinical studies.

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Posterior shoulder dislocation in a 10-year-old child: Case report.

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Seizure induced polytrauma; not just posterior dislocation of the shoulder.

Project description:A 61-year-old woman sustained multiple fractures secondary to the tonic clonic muscular contractions of a seizure. Her injuries included: bilateral proximal humerus posterior fracture dislocations, manubrium fracture, unstable sixth thoracic vertebrae crush fracture, bilateral acetabular fractures and a left femoral neck fracture. Seizures are a rare but recognised cause of fracture. Patients with osteoporosis are more susceptible to more serious fractures to long bones, spine and pelvis. The lack of history of high-energy trauma can lead to a delay in diagnosis. Rarely, the combination and magnitude of these injuries can be life-threatening.

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Congenital anterior shoulder dislocation in a newborn treated with closed reduction.

Project description:Case: This rare case presents an isolated congenital shoulder dislocation in a twin delivery, without traumatic delivery. Delivered by emergent cesarean section at 33 weeks gestation, the infant presented with a lateral shoulder crease with x-rays showing anterior and inferior dislocation. Treatment included prompt reduction and stabilization, with follow-up ultrasound demonstrating a physeal injury. Conclusions: This case report presents the only published congenital shoulder dislocation in an infant after an atraumatic twin cesarean delivery. Prompt reduction, stabilization, and ultrasound imaging to assess for physeal injury is our recommended management for this scenario.

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Project description: Not available

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