New technique in reconstructing humeral head defect in locked posterior dislocation of the shoulder: a case series of nine patients

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• 作者：Said K. Abdel-Hameed ; Mohamed A. Abdel-Aal
• 关键词：Locked posterior dislocation of the shoulder ; Reverse Hill ; Sachs lesion ; Anatomic reconstruction
• 刊名：European Orthopaedics and Traumatology
• 出版年：2015
• 出版时间：September 2015
• 年：2015
• 卷：6
• 期：3
• 页码：157-162
• 全文大小：2,682 KB
• 参考文献：1.Constant CR, Murley AH (1987) A clinical method of functional assessment of the shoulder. Clin Orthop Rel Res 214:160-64
  2.Checchia SL, Santos PD, Miyazaki AN (1998) Surgical treatment of acute and chronic posterior fracture dislocation of the shoulder. J Shoulder Elbow Surg 7(1):53-5View Article PubMed
  3.Wadlington VR, Hendrix RW, Rogers LF (1992) Computed tomography of posterior fracture-dislocations of the shoulder: case reports. J Trauma 32:113-15View Article PubMed
  4.Aparicio G, Calvo E, Bonilla L, Espejo L (2000) Neglected traumatic posterior dislocations of the shoulder: controversies on indications for treatment and new CT scan findings. J Orthop Sci 5:37-2View Article PubMed
  5.McLaughlin HL (1952) Posterior dislocation of the shoulder. J Bone Joint Surg Am 24:584-90PubMed
  6.Cicak N (2004) Posterior dislocation of the shoulder. J Bone Joint Surg (Br) 86:324-32View Article
  7.Keppler P, Holz U, Thielemann FW, Meinig R (1994) Locked posterior dislocation of the shoulder: treatment using rotational osteotomy of the humerus. J Orthop Trauma 8:286-92View Article PubMed
  8.Gerber C, Lambert SM (1996) Allograft reconstruction of segmental defects of the humeral head for the treatment of chronic locked posterior dislocation of the shoulder. J Bone Joint Surg Am 78:376-82PubMed
  9.Ozkan M, Gul O, Bacakoglu K, Ozcan C, Ekin A (2000) Treatment of posterior locked fracture dislocation of the shoulder with hemiarthroplasty. Acta Orthop Traumatol Turc 34:45-9
  10.Sperling JW, Cofield RH, Rowland CM (2004) Minimum 15?years follow-up of Neer hemiarthroplasty and total shoulder arthroplasty in patients aged 50?years or younger. J Shoulder Elbow Surg 13:604-13View Article PubMed
  11.Hawkins RJ, Neer CS, Pianta RM, Mendoza FX (1987) Locked posterior dislocation of the shoulder. Bone Joint Surg (Am) 69(1):9-8
  12.Robinson CM, Akhtar A, Mitchell M, Beavis C (2007) Complex posterior fracture dislocation of the shoulder. Epidemiology, injury patterns, and results of operative treatment. J Bone Joint Surg Am 89:1454-466View Article PubMed
  13.Randelli M, Gambrioli PL (2001) Chronic posterior dislocations of the shoulder. In: Duparc J (ed) Surgical techniques in orthopaedics and traumatology. Elsevier, Paris, 55-190-B-10
  14.Loebenberg MI, Cuomo F (2000) The treatment of chronic anterior and posterior dislocations of the glenohumeral joint and associated articular surface. Orthop Clin North Am 31(1):23-4View Article PubMed
  15.Delcogliano A, Caporaso A, Chiossi S, Delcogliano M (2005) Surgical management of chronic, unreduced posterior dislocation of the shoulder. Knee Surg Sports Traumatol Arthrosc 13(2):151-55View Article PubMed
  16.Bock P, Kluger R, Hintermann B (2007) Anatomical reconstruction for reverse Hill-Sachs lesions after posterior locked shoulder dislocation fracture. Arch Orthop Trauma Surg 127(7):543-48View Article PubMed
  17.Charalambous CP, Gullett TK, Ravenscroft MJ (2009) Modification of McLaughlin procedure for persistent shoulder instability: technical note. Arch Orthop Trauma Surg 129(6):753-55View Article PubMed
  
• 作者单位：Said K. Abdel-Hameed (1)
  Mohamed A. Abdel-Aal (2) (3)
  
  1. Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
  2. Orthopedic Surgery, El-Bakry General Hospital, Ministry of Health, Cairo, Egypt
  3. 61 Taha Heussein St., El-Nozha El-Gedida, Cairo, Egypt
  
• 刊物主题：Orthopedics; Traumatic Surgery; Conservative Orthopedics; Surgical Orthopedics; Sports Medicine;
• 出版者：Springer Berlin Heidelberg
• ISSN：1867-4577

文摘

Locked posterior dislocation of the shoulder is uncommon and frequently missed injury. It accounts for 2-?% of all shoulder dislocations. It is commonly associated with osseous defects in humeral head articular surface known as reverse Hill-Sachs lesion. Numerous surgical procedures are invented to repair this defect with variable outcomes, but evidence-based management strategies are lacking. Among these procedures are as follows: transfer of lesser tuberosity or subscapularis tendon, rotational osteotomy of humerus, osteochondral grafts. Salvage procedure as hemiarthroplasty or total shoulder arthroplasty used in huge non-constructable defect or very old neglected dislocation. In our case series, we treated nine cases (two females) of locked posterior dislocation of the shoulder with anteromedial humeral head defects ranging between 30 and 50?% of head size. Open reduction of dislocation followed by transfer of the lesser tuberosity together with subscapularis tendon for reconstruction of the humeral head defect. The transfer was fixed with Ethibond suture size 5- (Ethicon, Inc. Somerville, NJ). The mean follow-up period was 14.5?months (range 12-5?months). Seven cases had no pain or restriction of activities of daily living. No patient had symptoms of instability of the shoulder. According to UCLA shoulder rating scale, there were three cases rated excellent, four cases rated good, one case rated fair, and one case rated poor. It is concluded that reconstruction of the humeral head defect provides good pain relief, stability, and function for patients with a locked posterior dislocation of the shoulder where the defect involves between 30-0?% of the articular surface circumference. Our technique is simple, cheap, and there is no need for second operation for hardware removal.