Locked posterior dislocation of the shoulder

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Abstract

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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Most cited references 71

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Displaced proximal humeral fractures. II. Treatment of three-part and four-part displacement.

Charles Neer (1970)

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The epidemiology, risk of recurrence, and functional outcome after an acute traumatic posterior dislocation of the shoulder.

Philip C. Robinson, M Seah, M Kalim Akhtar (2011)

Posterior glenohumeral dislocation is less common than anterior dislocation, and less is known about its epidemiology, functional outcome, and complications. The purposes of this study were to determine the epidemiology and demographics of posterior dislocations and to assess the risk of recurrence and the functional outcome after treatment. We performed a retrospective review of a prospective audit of the cases of 112 patients who sustained 120 posterior glenohumeral dislocations. Patients were treated with relocation, immobilization, and then physical therapy. Functional outcome was assessed with the Western Ontario Shoulder Instability Index (WOSI) and the limb-specific Disabilities of the Arm, Shoulder and Hand score (DASH) during the two years after the dislocation. The prevalence of posterior dislocation was 1.1 per 100,000 population per year, with peaks in male patients between twenty and forty-nine years old, and in the elderly patients over seventy years old. Most dislocations (67%) were produced by a traumatic accident, with most of the remainder produced by seizures. Twenty patients (twenty-three shoulders) developed recurrent instability. On survival analysis, 17.7% (95% confidence interval, 10.8% to 24.6%) of the shoulders developed recurrent instability within the first year. On multivariable analysis, an age of less than forty years, dislocation during a seizure, and a large reverse Hill-Sachs lesion (>1.5 cm3) were predictive of recurrent instability. Small persistent functional deficits were detected with the WOSI and DASH at two years. The prevalence of posterior dislocation is low. The most common complication after this injury is recurrent instability, which occurs at an early stage in 17.7% of shoulders within the first year after dislocation. The risk is highest in patients who are less than forty years old, sustain the dislocation during a seizure, and have a large humeral head defect. The risk is lower for most patients who sustain the injury from a traumatic accident, especially if they are older and have a small anterior humeral head defect. There are persistent deficits of shoulder function within the first two years after the injury.

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Allograft reconstruction of segmental defects of the humeral head for the treatment of chronic locked posterior dislocation of the shoulder.

C. E. Gerber, Helen Lambert (1996)

The recognized options for the treatment of chronic locked posterior dislocation of the shoulder are dependent on the size of the anteromedial defect of the humeral head. Transfer of the lesser tuberosity with its attached subscapularis tendon into the defect is recommended for defects that are smaller than approximately 40 per cent of the joint surface. Prosthetic replacement is preferred for larger defects. Four consecutive patients who had a chronic locked posterior dislocation of the glenohumeral joint associated with a defect of the humeral head that was at least 40 per cent of the articular surface were managed with reconstruction of the shape of the humeral head with use of an allogeneic segment of the femoral head. Stability was restored and maintained in each patient at an average of sixty-eight months (range, sixty to seventy-six months) after the procedure. Three patients reported little or no pain and no or slight functional restrictions in the activities of daily living, and they considered the result to be satisfactory. The fourth patient had mild pain and moderate-to-severe dysfunction secondary to avascular necrosis of the remaining portion of the humeral head after a symptom-free period of six years.

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Author and article information

Journal

Journal ID (nlm-ta): EFORT Open Rev

Journal ID (iso-abbrev): EFORT Open Rev

Title: EFORT Open Reviews

Publisher: British Editorial Society of Bone and Joint Surgery

ISSN (Electronic): 2058-5241

Publication date Collection: January 2018

Publication date (Electronic): 15 January 2018

Volume: 3

Issue: 1

Pages: 15-23

Affiliations

[1 ]Agri State Hospital, Turkey

[2 ]Erzurum Training and Research Hospital, Turkey

[3 ]Kahta State Hospital, Turkey

Author notes

[*]Ozgur Basal, Ministry of Health, Agri State Hospital, Orthopaedics and Traumatology, Agri, Turkey. Email: basalozgur@ 123456gmail.com

Article

Publisher ID: 10.1302_2058-5241.3.160089

DOI: 10.1302/2058-5241.3.160089

PMC ID: 5890132

PubMed ID: 29657841

SO-VID: 0917fd48-89c8-4803-af25-ebd920da7cd6

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This article is distributed under the terms of the Creative Commons Attribution-Non Commercial 4.0 International (CC BY-NC 4.0) licence ( https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed.

Locked posterior dislocation of the shoulder : A systematic review

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Abstract

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EFORT Open Reviews

Most cited references 71

Displaced proximal humeral fractures. II. Treatment of three-part and four-part displacement.

The epidemiology, risk of recurrence, and functional outcome after an acute traumatic posterior dislocation of the shoulder.

Allograft reconstruction of segmental defects of the humeral head for the treatment of chronic locked posterior dislocation of the shoulder.

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