|
1
|
Aloui A, Cavailhès J, Coulomb R, Michaud J, Kouyoumdjian P, Mares O. Anatomical osteocartilaginous reconstruction of MacLaughlin lesion in chronic locked posterior shoulder dislocation: A novel technique. Int J Surg Case Rep 2025; 129:111116. [PMID: 40054406 PMCID: PMC11930201 DOI: 10.1016/j.ijscr.2025.111116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2025] [Revised: 02/21/2025] [Accepted: 03/01/2025] [Indexed: 03/26/2025] Open
Abstract
INTRODUCTION Chronic Posterior shoulder dislocation presents significant challenges, with treatment decisions influenced by the duration of the injury and the severity of humeral head damage. This report highlights an innovative technique for reconstructing humeral head defects using an osteocartilaginous graft from costal cartilage, offering insights into the surgical procedure and the patient's favorable recovery outcomes. PRESENTATION OF CASE The patient, a 23-year-old male with no significant medical history, was treated for a neglected posterior shoulder dislocation of two months' duration, complicated by a reverse Hill-Sachs lesion. The treatment involved an open reduction and reconstruction of the reverse Hill-Sachs lesion using costal cartilage. At the six-month follow-up, the patient was evaluated and demonstrated excellent shoulder function, with a Constant score of 92.5. DISCUSSION This technique introduces costal cartilage grafting for reverse Hill-Sachs lesion reconstruction, offering a novel anatomical approach to restore humeral head integrity. Unlike traditional methods, it ensures excellent biocompatibility, joint congruence, and stability while preserving shoulder mobility. Costal cartilage is abundant, versatile, and widely used in reconstructive surgery, yet its application in posterior shoulder dislocation remains unexplored. This method avoids tendon transfer complications and hardware-related issues, providing a promising alternative with reduced long-term risks and improved functional outcomes. CONCLUSION Our technique utilizing an osteocartilaginous graft harvested from the costal cartilage, combined with meticulous soft tissue management, demonstrated a promising approach to reconstruct the humeral head and restore shoulder stability for chronic posterior shoulder dislocation with large reverse Hill-Sachs lesion.
Collapse
Affiliation(s)
- Ala Aloui
- University Hospital Center of Nîmes, 4 Professeur Robert Debré street, 30900 Nîmes, France.
| | - Jules Cavailhès
- Faculty of Medicine Montpellier-Nîmes, 186 Carreau de Lanes Road, 30900 Nîmes, France.
| | - Remy Coulomb
- University Hospital Center of Nîmes, 4 Professeur Robert Debré street, 30900 Nîmes, France.
| | - Jeffrey Michaud
- Faculty of Medicine Montpellier-Nîmes, 186 Carreau de Lanes Road, 30900 Nîmes, France.
| | - Pascal Kouyoumdjian
- Faculty of Medicine Montpellier-Nîmes, 186 Carreau de Lanes Road, 30900 Nîmes, France.
| | - Olivier Mares
- University Hospital Center of Nîmes, 4 Professeur Robert Debré street, 30900 Nîmes, France.
| |
Collapse
|
|
2
|
Watson L, Hoy G, Barwood S, Pizzari T, Balster S, Mulholland J, French J, Lawrence S, Verdon D, Warby S. The Posterior Shoulder Instability Questionnaire: internal consistency, content and criterion validity, responsiveness, and reliability of a new tool for the assessment of posterior shoulder instability. J Shoulder Elbow Surg 2024; 33:e616-e628. [PMID: 38821172 DOI: 10.1016/j.jse.2024.03.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 03/05/2024] [Accepted: 03/29/2024] [Indexed: 06/02/2024]
Abstract
BACKGROUND Posterior shoulder instability (PSI) is an increasingly recognized cause of shoulder dysfunction particularly in young active patients and certain athlete populations. When evaluating the efficacy of treatment for PSI, specific outcome measures for this population are essential. The aim of the current research was to describe the development and evaluation of a patient reported outcome measure specific for PSI. METHODS A retrospective cohort study design of patients with PSI was used to develop and evaluate the "Posterior Shoulder Instability Questionnaire (PSI-Q)". Items for PSI-Q were generated through an expert focus group and existing questionnaires. Preliminary data analysis identified redundancy of items and resulted in the PSI-Q being refined. The final PSI-Q was evaluated on 128 patients with PSI with a structural lesion requiring surgical intervention. Participants were excluded in the absence of a posterior glenohumeral joint lesion. Internal consistency (Cronbach α and corrected item-total correlation), content validity, criterion validity, responsiveness, and test-retest reliability (intraclass correlation coefficient) were examined. Content validity, criterion validity and responsiveness were compared with the Melbourne Instability Shoulder Scale (MISS) and the Western Ontario Shoulder Instability Index (WOSI). The minimum detectable change score (MDC) was calculated. RESULTS The Cronbach α for the total scale preintervention and postintervention was high (α = 0.97). All five domains (pain, instability/weakness/stiffness, function, occupation and sport, and quality of life and satisfaction) demonstrated acceptable internal consistency for each subsection and the overall score of the scale (α > 0.70). The corrected-item total correlation for each domain was within an acceptable range. The responsiveness of the PSI-Q questionnaire was excellent (effect size, 2.06; standard response mean, 1.34) and was higher than the MISS and WOSI. There were no relevant floor effects and 1 ceiling effect. Reliability was excellent (intraclass correlation coefficient(1,1) = 0.93) and the calculated MDC was 10.9 points. DISCUSSION This study designed and validated a questionnaire specific for measuring symptoms and function in people with structural PSI requiring surgery. The PSI-Q demonstrates good measurement properties and provides an MDC that is useful for researchers and clinicians. In structural PSI, the PSI-Q has a higher responsiveness and more accurately reflects a patient's overall perceived shoulder status compared to current patient reported outcomes for shoulder instability. The psychometric properties of the PSI-Q are still to be determined in a nonsurgical population.
Collapse
Affiliation(s)
- Lyn Watson
- Melbourne Shoulder Group, Prahran, Victoria, Australia
| | - Gregory Hoy
- Melbourne Orthopaedic Group, Windsor, Victoria, Australia; Monash Medical Centre, Department of Surgery, Monash University, Clayton, Victoria, Australia; Glenferrie Private Hospital, Hawthorn, Victoria, Australia
| | - Shane Barwood
- Melbourne Orthopaedic Group, Windsor, Victoria, Australia
| | - Tania Pizzari
- Melbourne Shoulder Group, Prahran, Victoria, Australia; Mill Park Physiotherapy, South Morang, Victoria, Australia
| | - Simon Balster
- Melbourne Shoulder Group, Prahran, Victoria, Australia
| | | | | | - Sam Lawrence
- Melbourne Shoulder Group, Prahran, Victoria, Australia
| | - Daniel Verdon
- Melbourne Shoulder Group, Prahran, Victoria, Australia
| | - Sarah Warby
- Melbourne Shoulder Group, Prahran, Victoria, Australia; Department of Physiotherapy, Podiatry, Prosthetics and Orthotics, La Trobe University, Bundoora, Victoria, Australia.
| |
Collapse
|
|
3
|
Koide M, Tateda S, Miyasaka S, Yasuyama A, Sasaki Y, Abe M. A Case of Neglected Posterior Fracture Dislocation of the Shoulder Treated With Greater Tuberosity Osteotomy. Case Rep Orthop 2024; 2024:6486750. [PMID: 38962284 PMCID: PMC11221983 DOI: 10.1155/2024/6486750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 05/07/2024] [Accepted: 05/29/2024] [Indexed: 07/05/2024] Open
Abstract
Posterior dislocation of the shoulder joint is a rare condition. It is often misdiagnosed owing to a lack of evident clinical features compared with anterior shoulder dislocation, and inappropriate radiological examination. We present a case of chronic posterior fracture dislocation treated with greater tuberosity osteotomy. A 66-year-old man was injured in a fall while carrying a drone. He was referred to our hospital following 3 months of conservative treatment at a nearby clinic, without reduction of the posterior dislocation. Physical examination revealed a prominent reduction in shoulder joint range of motion and shoulder pain. Radiological examination revealed posterior shoulder dislocation associated with greater tuberosity malunion and a small bone fracture of the posterior portion of the glenoid. Open reduction and internal fixation, including greater tuberosity osteotomy, were performed. Although subluxation of the posterior dislocation persisted postoperatively, the humeral head gradually returned to its centric shoulder joint position owing to rotator cuff force coupling. At 24-month follow-up, the patient showed excellent shoulder results.
Collapse
Affiliation(s)
- Masashi Koide
- Department of Orthopedic SurgeryJapanese Red Cross Ishinomaki Hospital, Ishinomaki, Japan
| | - Satoshi Tateda
- Department of Orthopedic SurgeryJapanese Red Cross Ishinomaki Hospital, Ishinomaki, Japan
| | - Sayaka Miyasaka
- Department of Orthopedic SurgeryJapanese Red Cross Ishinomaki Hospital, Ishinomaki, Japan
| | - Akihiro Yasuyama
- Department of Orthopedic SurgeryJapanese Red Cross Ishinomaki Hospital, Ishinomaki, Japan
| | - Yoichi Sasaki
- Department of Orthopedic SurgeryJapanese Red Cross Ishinomaki Hospital, Ishinomaki, Japan
| | - Mika Abe
- Department of Orthopedic SurgeryJapanese Red Cross Ishinomaki Hospital, Ishinomaki, Japan
| |
Collapse
|
|
4
|
Roy M, Bhikshavarthi Math SA, Tiwari V, Dwidmuthe S. Neglected Anterior Shoulder Dislocation With Greater Tuberosity Fracture Managed With Open Reduction and Latarjet Procedure: A Case Report. Cureus 2024; 16:e60333. [PMID: 38883054 PMCID: PMC11177244 DOI: 10.7759/cureus.60333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2024] [Indexed: 06/18/2024] Open
Abstract
Neglected shoulder dislocation is a relatively rare occurrence characterized by structural changes in bone and soft tissue. Surgical intervention is often necessary, yet no universally accepted treatment approach exists, presenting a challenging clinical scenario. A 45-year-old female presented with an eight-month-old neglected anterior shoulder dislocation, compounded by a Hill-Sachs lesion from a previous fall. Treatment comprised open reduction in conjunction with the Latarjet procedure. Regular follow-up evaluations were conducted over three years post-surgery, revealing satisfactory outcomes including good range of motion, bony union, and absence of dislocation episodes. Managing neglected shoulder dislocations, particularly those with significant bone defects, poses unique challenges involving soft tissue contracture, bone loss, and associated fractures. Despite these complexities, open reduction combined with the Latarjet procedure demonstrated a high success rate in preventing further shoulder dislocation, albeit with a persistent risk of shoulder joint osteoarthritis.
Collapse
Affiliation(s)
- Mainak Roy
- Orthopaedics, All India Institute of Medical Sciences, Nagpur, Nagpur, IND
| | | | | | - Samir Dwidmuthe
- Orthopaedics, All India Institute of Medical Sciences, Nagpur, Nagpur, IND
| |
Collapse
|
|
5
|
Congia S, Uccheddu G, Pisu R, Varverakis A, Moro G, Ferreli A, Puddu G, Carboni G. Pragmatic use of ultrasound in plaster room. JOURNAL OF CLINICAL ULTRASOUND : JCU 2024; 52:448-455. [PMID: 38348905 DOI: 10.1002/jcu.23642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 01/02/2024] [Accepted: 01/21/2024] [Indexed: 02/29/2024]
Abstract
X-ray represent gold standard to check reduction of fractures and dislocations. Sometimes plaster room is not equipped with C-arm or similar devices. Practical and focused use of ultrasound in plaster room cannot replace X-ray but may be a useful tool especially in tricky situations. We report three emblematic cases and we carry out a review of the literature.
Collapse
Affiliation(s)
- Stefano Congia
- Orthopaedic and Traumatology Division, Nostra Signora di Bonaria Hospital, ASL Medio Campidano, San Gavino Monrele, Italy
| | | | - Roberta Pisu
- Orthopaedic and Traumatology Division, Sirai Hospital, ASL Sulcis, Carbonia, Italy
| | - Andrea Varverakis
- Orthopaedic and Traumatology Division, Sirai Hospital, ASL Sulcis, Carbonia, Italy
| | - Giorgia Moro
- Orthopaedic and Traumatology Division, Nostra Signora di Bonaria Hospital, ASL Medio Campidano, San Gavino Monrele, Italy
| | - Alberto Ferreli
- Orthopaedic and Traumatology Division, Sirai Hospital, ASL Sulcis, Carbonia, Italy
| | - Gianfranco Puddu
- Orthopaedic and Traumatology Division, Nostra Signora di Bonaria Hospital, ASL Medio Campidano, San Gavino Monrele, Italy
| | - Giorgio Carboni
- Orthopaedic and Traumatology Division, Nostra Signora di Bonaria Hospital, ASL Medio Campidano, San Gavino Monrele, Italy
| |
Collapse
|
|
6
|
Testa EJ, van der List JP, Waterman BR, Caldwell PE, Parada SA, Owens BD. Management of Bone Loss in Posterior Glenohumeral Shoulder Instability: Current Concepts. JBJS Rev 2024; 12:01874474-202404000-00005. [PMID: 38619382 DOI: 10.2106/jbjs.rvw.23.00243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
» Posterior glenohumeral instability is relatively uncommon compared with anterior instability, but is becoming an increasingly recognized and surgically managed shoulder pathology.» Soft-tissue stabilization alone may not be sufficient in patients who present with substantial bone loss to the posterior glenoid and/or the anterior humeral head.» For posterior glenoid defects, posterior glenoid osteoarticular augmentation can be used, and posterior glenoid opening wedge osteotomy can be considered in cases of posterior instability with pathologic retroversion.» For humeral head lesions, several surgical treatment options are available including subscapularis transposition into the humeral head defect, autograft or allograft reconstruction, humeral rotation osteotomy, and shoulder arthroplasty.
Collapse
Affiliation(s)
- Edward J Testa
- Department of Orthopaedic Surgery, Brown University, Warren Alpert School of Medicine, Providence, Rhode Island
| | - Jelle P van der List
- Department of Orthopaedic Surgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Brian R Waterman
- Department of Orthopaedic Surgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Paul E Caldwell
- Orthopaedic Research of Virginia, Richmond, Virginia
- Tuckahoe Orthopaedic Associates, Richmond, Virginia
| | - Stephen A Parada
- Medical College of Georgia at Augusta University, Augusta, Georgia
| | - Brett D Owens
- Department of Orthopaedic Surgery, Brown University, Warren Alpert School of Medicine, Providence, Rhode Island
| |
Collapse
|
|
7
|
Khanna A, Fares MY, Koa J, Boufadel P, Lopez RD, Abboud JA. Clinical, Diagnostic, and Therapeutic Characteristics of Posterior Glenohumeral Instability. THE ARCHIVES OF BONE AND JOINT SURGERY 2024; 12:820-825. [PMID: 39720546 PMCID: PMC11664744 DOI: 10.22038/abjs.2024.81046.3697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Accepted: 09/23/2024] [Indexed: 12/26/2024]
Abstract
Posterior shoulder instability (PSI) is a shoulder pathology that is challenging to diagnose, leading to treatment delay and exacerbation of symptoms. Etiology can be both traumatic and atraumatic, and a comprehensive clinical history plays a significant role in achieving diagnosis. Imaging in the setting of PSI can reveal a reverse-Bankart lesion, a reverse Hill-Sachs lesion, posterior labral cysts, and potentially glenoid or lesser tuberosity fractures. Both conservative and surgical options exist for patients with PSI, and management often depends on case severity, extent of bone loss, and patient goals and expectations. Holistic patient education regarding the etiologies, mechanisms and possible treatment options available is pivotal for achieving high levels of patient satisfaction and optimal outcomes.
Collapse
Affiliation(s)
- Akshay Khanna
- Division of Shoulder and Elbow Surgery, Rothman Orthopaedic Institute, Philadelphia, PA, USA
| | - Mohamad Y Fares
- Division of Shoulder and Elbow Surgery, Rothman Orthopaedic Institute, Philadelphia, PA, USA
| | - Jonathan Koa
- Division of Shoulder and Elbow Surgery, Rothman Orthopaedic Institute, Philadelphia, PA, USA
| | - Peter Boufadel
- Division of Shoulder and Elbow Surgery, Rothman Orthopaedic Institute, Philadelphia, PA, USA
| | - Ryan D Lopez
- Division of Shoulder and Elbow Surgery, Rothman Orthopaedic Institute, Philadelphia, PA, USA
| | - Joseph A Abboud
- Division of Shoulder and Elbow Surgery, Rothman Orthopaedic Institute, Philadelphia, PA, USA
| |
Collapse
|
|
8
|
Watson L, Hoy G, Wood T, Pizzari T, Balster S, Barwood S, Warby SA. Posterior Shoulder Instability in Tennis Players: Aetiology, Classification, Assessment and Management. Int J Sports Phys Ther 2023; V18:769-788. [PMID: 37425109 PMCID: PMC10324327 DOI: 10.26603/001c.75371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 03/14/2023] [Indexed: 07/11/2023] Open
Abstract
Background Micro-traumatic posterior shoulder instability (PSI) is an often missed and misdiagnosed pathology presenting in tennis players. The aetiology of micro-traumatic PSI in tennis players is multifactorial, including congenital factors, loss of strength and motor control, and sport-specific repetitive microtrauma. Repetitive forces placed on the dominant shoulder, particularly combinations of flexion, horizontal adduction, and internal rotation contribute to the microtrauma. These positions are characteristic for kick serves, backhand volleys, and the follow-through phase of forehands and serves. The aim of this clinical commentary is to present an overview of the aetiology, classification, clinical presentation, and treatment of micro-traumatic PSI, with a particular focus on tennis players. Level of Evidence 5.
Collapse
Affiliation(s)
- Lyn Watson
- Melbourne Shoulder Group, 305 High Street, Prahran, Victoria, Australia, 3181
| | - Gregory Hoy
- Melbourne Orthopaedic Group, 33 The Avenue Windsor, Victoria, Australia, 3181
- Monash University, Department of Surgery, Monash Medical Centre Level 5, Block E 246 Clayton Road Clayton, Victoria, Australia, 3168
- Glenferrie Private Hospital, 25 Linda Crescent, Hawthorn, Victoria, Australia, 3122
| | - Timothy Wood
- Glenferrie Private Hospital, 25 Linda Crescent, Hawthorn, Victoria, Australia, 3122
| | - Tania Pizzari
- Melbourne Shoulder Group, 305 High Street, Prahran, Victoria, Australia, 3181
- Mill Park Physiotherapy, 22/1 Danaher Dr, South Morang, Victoria, Australia, 37522
- La Trobe University, Department of Physiotherapy, Podiatry, Prosthetics and Orthotics, Corner of Kingsbury Drive and Plenty Road Bundoora, Victoria, Australia, 3080
| | - Simon Balster
- Melbourne Shoulder Group, 305 High Street, Prahran, Victoria, Australia, 3181
| | - Shane Barwood
- Melbourne Orthopaedic Group, 33 The Avenue Windsor, Victoria, Australia, 3181
| | - Sarah Ann Warby
- Melbourne Shoulder Group, 305 High Street, Prahran, Victoria, Australia, 3181
- La Trobe University, Department of Physiotherapy, Podiatry, Prosthetics and Orthotics, Corner of Kingsbury Drive and Plenty Road Bundoora, Victoria, Australia, 3080
| |
Collapse
|
|
9
|
Zari S, Sammouni O, Abdeljaouad N, Yacoubi H. Neglected Anterior Shoulder Dislocation Treated With Open Reduction and Latarjet Procedure: A Case Report. Cureus 2023; 15:e35347. [PMID: 36994291 PMCID: PMC10042543 DOI: 10.7759/cureus.35347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2023] [Indexed: 02/25/2023] Open
Abstract
According to the literature, cases of neglected anterior shoulder dislocation are extremely rare, which still presents diagnostic and treatment challenges. An extensive surgical procedure is required for their treatment. This situation is still challenging, and there is currently no accepted therapeutic protocol to resolve it. We report the case of a 30-year-old patient who had a right shoulder trauma with an unnoticed antero-medial dislocation. The treatment established was an open reduction combined with the Latarjet procedure followed by good results.
Collapse
|
|
10
|
Mencia MM, Goalan R. Bilateral Posterior Fracture-Dislocation of the Shoulders Secondary to Uremic Encephalopathy. J Am Acad Orthop Surg Glob Res Rev 2023; 7:01979360-202301000-00002. [PMID: 37796759 PMCID: PMC9820790 DOI: 10.5435/jaaosglobal-d-20-00255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 12/02/2021] [Indexed: 10/07/2023]
Abstract
Bilateral posterior fracture-dislocation of the shoulder is an uncommon injury pattern usually caused by epileptic seizures. The cause of the seizure activity remains unknown in most cases, although the injury has been associated with several conditions. A 59-year-old man with uncontrolled hypertension presented with new-onset generalized tonic-clonic seizures. He was diagnosed with uremic encephalopathy and bilateral posterior fracture-dislocation of his shoulders. His medical condition required stabilization leading to a delay in definitive surgery and a subsequent poor outcome. This case highlights the previously unknown association between bilateral fracture-dislocation of the shoulders and seizures caused by uremic encephalopathy. In these complex situations with competing clinical priorities, it is important to initiate prompt treatment of the cause in any new-onset seizures, to facilitate expedient surgical management of the orthopaedic injury.
Collapse
Affiliation(s)
- Marlon M Mencia
- Department of Clinical Surgical Sciences, University of the West Indies, Port of Spain, Trinidad and Tobago (Mencia), and Department of Orthopaedics, Eric Williams Medical Sciences Complex, Trinidad and Tobago (Goalan)
| | | |
Collapse
|
|
11
|
Kandeel AAM. Chronic locked posterior gleno-humeral dislocation: technical note on fibular grafting for restoration of humeral head sphericity. J Orthop Surg Res 2021; 16:683. [PMID: 34794483 PMCID: PMC8600741 DOI: 10.1186/s13018-021-02835-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 11/09/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Reconstruction 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. METHODS Following 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. RESULTS Spherical 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. CONCLUSION Currently 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.
Collapse
Affiliation(s)
- Amr Abdel-Mordy Kandeel
- Department of Orthopedics and Traumatology, Faculty of Medicine, Menoufia University, Gamal Abdel-Nasser Street, Shebien El-kom, Menoufia Governorate, Egypt.
| |
Collapse
|
|
12
|
Zanini B, Rusconi M, Fornara P, Grassi FA. Bilateral neglected posterior dislocation of the shoulder treated by reverse arthroplasty and contralateral osteochondral autograft. A case report. Trauma Case Rep 2021; 33:100455. [PMID: 33851000 PMCID: PMC8038943 DOI: 10.1016/j.tcr.2021.100455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2021] [Indexed: 11/23/2022] Open
Abstract
Bilateral posterior dislocation of the glenohumeral joint is an uncommon event, that can be missed at the initial presentation. We report the case of a 76-year old woman, who suffered a traumatic bilateral posterior dislocation, that was diagnosed three months later. She underwent surgical treatment on both shoulders in a single stage. Since the right shoulder showed a defect of the articular surface >50%, a reverse shoulder arthroplasty was performed on this side. The resected portion of the humeral head was retrieved and used as osteochondral graft to fill the reverse Hill-Sachs lesion of the left shoulder. At 18-month follow up, the patient was pain-free and had recovered excellent shoulder function on both sides: Constant score was 79 for the right shoulder and 88 for the left one. X-rays showed a grade 1 scapular notch of the right reverse prosthesis and good incorporation of the graft in the left shoulder, with no evidence of degenerative joint changes. Neglected posterior dislocations of the shoulder can be surgically treated by replacement or reconstruction. In case of bilateral injuries, the surgeon should carefully evaluate the pathoanatomy of both glenohumeral joints in order to choose and plan the most suitable procedure. If shoulder replacement is required on one side, the resected portion of the humeral head can be used as osteochondral autograft for a reconstruction procedure in the opposite side. The choice is influenced by several variables and decision-making might be challenging.
Collapse
Affiliation(s)
- Beatrice Zanini
- Orthopaedic and Trauma Unit, Hospital “Maggiore della Carità”, Novara, Italy
- Department of Health Sciences, University of East Piedmont, Novara, Italy
| | - Mattia Rusconi
- Orthopaedic and Trauma Unit, Hospital “Maggiore della Carità”, Novara, Italy
- Department of Health Sciences, University of East Piedmont, Novara, Italy
| | - Paolo Fornara
- Orthopaedic and Trauma Unit, Hospital “Maggiore della Carità”, Novara, Italy
| | - Federico Alberto Grassi
- Orthopaedic and Trauma Unit, Hospital “Maggiore della Carità”, Novara, Italy
- Department of Health Sciences, University of East Piedmont, Novara, Italy
| |
Collapse
|
|
13
|
Ippolito G, Zitiello M, De Marinis G, D’Angelo F, Surace MF, Ronga M, Sepe V, Garro L, Faoro L, Ferraro S. Posterior Shoulder Dislocation with Engaging Reverse Hill-Sachs Lesion: A Retrospective Study of Ten Patients Treated with Arthroscopy or Open Reduction and Stabilization. J Clin Med 2021; 10:1410. [PMID: 33915791 PMCID: PMC8037443 DOI: 10.3390/jcm10071410] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 03/09/2021] [Accepted: 03/24/2021] [Indexed: 11/25/2022] Open
Abstract
This study compares two surgical techniques used to treat patients with posterior shoulder dislocation with an engaging reverse Hill-Sachs lesion. We assessed ten patients who were treated at the Surgical Orthopedic and Traumatological Institute (ICOT) of Latina and the Clinic of Orthopedic and Traumatological Surgery of the ASST Sette Laghi of Varese between 2016 and 2019. The patients were divided into two groups: the first comprising six patients who underwent the open surgery McLaughlin procedure as modified by Neer, the second including four patients who underwent the arthroscopic McLaughlin procedure. All patients received postoperative rehabilitation to achieve the best possible functional recovery of the affected shoulder. We then assessed the shoulder range of motion, the pain level, and the impact on quality of life with four tests: the Constant Scale, the Simple Shoulder Test (SST), the OXFORD Scale, and The University of California-Los Angeles (UCLA) Shoulder Scale. The mean scores of the first group were: 81.3 ± 9.8 SD (Constant Scale), 10.8 ± 1.06 SD (SST), 42.5 ± 5.4 SD (Oxford Scale), 30.8 ± 3.02 SD (UCLA Shoulder Scale); we calculated the following mean scores in the second group: 80.25 ± 4.1 SD (Constant Scale), 11.5 ± 0.8 SD (SST), 42 ± 4.06 SD (Oxford Scale), 32 ± 2.9 SD (UCLA Shoulder Scale). We found no significant differences between the two groups.
Collapse
Affiliation(s)
- Giorgio Ippolito
- Dipartimento di Scienze e Biotecnologie Medico Chirurgiche (DSBMC), Sapienza Università di Roma, Polo Pontino ICOT, 04100 Latina, Italy
| | - Michele Zitiello
- Istituto Chirurgico Ortopedico Traumatologico (ICOT), 04100 Latina, Italy; (M.Z.); (G.D.M.); (V.S.)
| | - Giancarlo De Marinis
- Istituto Chirurgico Ortopedico Traumatologico (ICOT), 04100 Latina, Italy; (M.Z.); (G.D.M.); (V.S.)
| | - Fabio D’Angelo
- Ospedale di Circolo, Fondazione Macchi “Università Insubria”, 21100 Varese, Italy; (F.D.); (L.F.); (S.F.)
| | - Michele F. Surace
- Dipartimento di Biotecnologie e Scienze Della Vita, Università Insubria, 21100 Varese, Italy;
| | - Mario Ronga
- Azienda Ospedaliera Policlinico Universitario “G. Martino”, 98124 Messina, Italy;
| | - Vincenzo Sepe
- Istituto Chirurgico Ortopedico Traumatologico (ICOT), 04100 Latina, Italy; (M.Z.); (G.D.M.); (V.S.)
| | - Luca Garro
- Casa di Cura Villa Betania Giomi SpA, 00165 Roma, Italy;
| | - Luca Faoro
- Ospedale di Circolo, Fondazione Macchi “Università Insubria”, 21100 Varese, Italy; (F.D.); (L.F.); (S.F.)
| | - Sergio Ferraro
- Ospedale di Circolo, Fondazione Macchi “Università Insubria”, 21100 Varese, Italy; (F.D.); (L.F.); (S.F.)
| |
Collapse
|
|
14
|
Kazamias K, Bisbinas V, Markopoulos G, Pellios S, Bisbinas I. Posterior shoulder dislocation with reverse Hill-Sachs lesion. A technical note and report of two cases. SICOT J 2021; 7:24. [PMID: 33812471 PMCID: PMC8019564 DOI: 10.1051/sicotj/2021022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 03/11/2021] [Indexed: 11/14/2022] Open
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.
Collapse
Affiliation(s)
- Konstantinos Kazamias
- Lieutenant and Resident in Orthopaedics and Trauma Surgery, Department of 1st Orthopaedic and Trauma, 424 Army General Training Hospital, 56429 Thessaloniki, Greece
| | - Vasiliki Bisbinas
- S.H.O. in Orthopaedics and Trauma, Department of Orthopaedic and Trauma, Conquest Hospital, Hastings, TN37 7RD East Sussex, UK
| | - George Markopoulos
- Major and Consultant in Orthopaedics and Trauma Surgery, Department of 1st Orthopaedic and Trauma, 424 Army General Training Hospital, 56429 Thessaloniki, Greece
| | - Stavros Pellios
- Major and Consultant in Orthopaedics and Trauma Surgery, Department of 1st Orthopaedic and Trauma, 424 Army General Training Hospital, 56429 Thessaloniki, Greece
| | - Ilias Bisbinas
- Col and Consultant in Orthopaedics and Trauma Surgery, Chief of the Department of 1st Orthopaedic and Trauma, 424 Army General Training Hospital, 56429 Thessaloniki, Greece
| |
Collapse
|
|
15
|
Matthewson G, Wong IH. Posterior Glenohumeral Capsular Reconstruction With Modified McLaughlin for Chronic Locked Posterior Dislocation. Arthrosc Tech 2019; 8:e1543-e1550. [PMID: 31890535 PMCID: PMC6928361 DOI: 10.1016/j.eats.2019.08.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 08/12/2019] [Indexed: 02/03/2023] Open
Abstract
Posterior instability is relatively rare when compared with anterior instability but can comprise up to 40% of operatively treated instability cases. Posterior dislocations are much rarer and are classically due to trauma, seizure, or electric shock. Due to a lack of an obvious deformity and an internally rotated and adducted arm position, posterior shoulder dislocations often are missed on initial presentation. In the management of posterior dislocations, considerations need to be made in regard to bony and soft-tissue pathology. In the setting of soft-tissue deficiency, previous options included nonoperative management primarily consisting of bracing and activity modification as well as arthroplasty options that do not rely on the capsulolabral complex for stability. In this paper, we present a technique for treating a chronic posterior shoulder dislocation with an associated large reverse Hill-Sachs deformity. In this setting, a revision labral repair and capsulodesis is generally not possible due to insufficient capsulolabral tissues. Here, we present the technique for an arthroscopic posterior capsule reconstruction using an acellular dermal allograft as well as a McLaughlin procedure for the treatment of a reverse Hill-Sachs lesion.
Collapse
Affiliation(s)
| | - Ivan H. Wong
- Division of Orthopaedic Surgery, Department of Surgery, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| |
Collapse
|
|
16
|
Sayal A. Emergency Medicine Orthopedic Assessment: Pearls and Pitfalls. Emerg Med Clin North Am 2019; 38:1-13. [PMID: 31757244 DOI: 10.1016/j.emc.2019.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Acute musculoskeletal injuries are commonly seen in our emergency departments, and are commonly missed. There are many reasons for more missed injures and a significant one is over-reliance on radiographs. An emergency department orthopedic assessment goes far beyond the radiographs. A focused, yet comprehensive history is vital to understand the forces and mechanism of injury. That injury must be understood in the context of the patient, because older and much younger patients have weaker bone. Finally, the physical examination is instrumental in localizing the pathology and is essential to put radiograph results in the proper clinical context.
Collapse
Affiliation(s)
- Arun Sayal
- Emergency Department and Fracture Clinic, North York General Hospital, Faculty of Medicine, University of Toronto, Room NW-126, 4001 Leslie Street, Toronto, Ontario M2K 1E1, Canada.
| |
Collapse
|
|
17
|
Prasathaporn N, Laohathaimongkol T, Umprai V, Kuptniratsaikul V. Arthroscopically Assisted Reduction in a Chronic Locked Posterior Shoulder Dislocation. Arthrosc Tech 2019; 8:e769-e774. [PMID: 31485405 PMCID: PMC6714613 DOI: 10.1016/j.eats.2019.03.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 03/13/2019] [Indexed: 02/03/2023] Open
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.
Collapse
Affiliation(s)
| | | | | | - Vanasiri Kuptniratsaikul
- Address correspondence to Vanasiri Kuptniratsaikul, M.D., Department of Orthopaedics, Queen Savang Vadhana Memorial Hospital, 290 Jermjomphol Rd, Sriracha Province, Chonburi, Thailand.
| |
Collapse
|
|
18
|
Aydin N, Enes Kayaalp M, Asansu M, Karaismailoglu B. Treatment options for locked posterior shoulder dislocations and clinical outcomes. EFORT Open Rev 2019; 4:194-200. [PMID: 31191987 PMCID: PMC6540946 DOI: 10.1302/2058-5241.4.180043] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Posterior dislocations are rare and diagnostically difficult injuries. Diagnosis is often delayed and this leads to a locked posteriorly dislocated humeral head. Treatment options include conservative methods and surgical anatomic reconstruction options as well as non-anatomic surgical procedures such as subscapularis tendon transfer, hemiarthroplasty and total shoulder arthroplasty. Decision-making for treatment as well as prognosis depend on the extent of the articular defect size of the humeral head, duration of the dislocation and patient-specific conditions such as age and activity levels. Cite this article: EFORT Open Rev 2019;4:194-200. DOI: 10.1302/2058-5241.4.180043
Collapse
Affiliation(s)
- Nuri Aydin
- Istanbul University - Cerrahpasa, Cerrahpasa Medical Faculty, Orthopaedics and Traumatology Department, Istanbul, Turkey
| | - Mahmut Enes Kayaalp
- Istanbul University - Cerrahpasa, Cerrahpasa Medical Faculty, Orthopaedics and Traumatology Department, Istanbul, Turkey
| | - Mustafa Asansu
- Baltalimani Bone Diseases Training and Research Hospital, Orthopaedics and Traumatology Department, Istanbul, Turkey
| | - Bedri Karaismailoglu
- Istanbul University - Cerrahpasa, Cerrahpasa Medical Faculty, Orthopaedics and Traumatology Department, Istanbul, Turkey
| |
Collapse
|
|
19
|
Lubis AMT, Primaputra MRA, Dilogo IH. A case report of ten-month-neglected anterior shoulder dislocation managed by open reduction combined with Latarjet procedure. Int J Surg Case Rep 2019; 57:93-96. [PMID: 30928782 PMCID: PMC6441765 DOI: 10.1016/j.ijscr.2019.03.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 02/25/2019] [Accepted: 03/09/2019] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Neglected shoulder dislocation is a rare case and may be accompanied by pathological changes in bony and soft tissue structure. Therefore, it requires extensive surgical procedure. Until now, there is no standard treatment protocol to overcome this case and it is still a challenging case. PRESENTATION OF CASE We presented a 27-year-old male patient with deformity on his left shoulder. The patient has suffered a ten-month-neglected anterior shoulder dislocation with a Hill-Sachs lesion. The treatment was open reduction combined with Latarjet procedure. Evaluation of treatment was performed three months after surgery. DISCUSSION Management of a neglected shoulder dislocation, especially with significant bony defects, is challenging and cannot be managed with standard surgical technique because of severe soft-tissue contracture and imbalance as well as bone deficiency. Chronic locked anterior shoulder dislocation is a difficult condition for both patient and clinician. In addition to that, the treatment results can be unsatisfactory. Latarjet procedure has been shown to be effective for the treatment of recurrent anterior shoulder dislocation with a large glenoid osseous defect which might justify the application of this procedure for the treatment of neglected anterior shoulder dislocation. CONCLUSION Open reduction combined with Latarjet procedure performed for treatment of neglected anterior shoulder dislocation was found to have a high rate of successful in preventing further dislocation of the shoulder joint although the high risk of osteoarthritis of the shoulder joint can still persist.
Collapse
Affiliation(s)
- Andri Maruli Tua Lubis
- Department of Orthopaedics and Traumatology, Cipto Mangunkusumo General Hospital/Faculty of Medicine Universitas Indonesia, Salemba Raya No. 6, Jakarta 10430, Indonesia.
| | - Muhammad Rizqi Adhi Primaputra
- Department of Orthopaedics and Traumatology, Cipto Mangunkusumo General Hospital/Faculty of Medicine Universitas Indonesia, Salemba Raya No. 6, Jakarta 10430, Indonesia
| | - Ismail H Dilogo
- Department of Orthopaedics and Traumatology, Cipto Mangunkusumo General Hospital/Faculty of Medicine Universitas Indonesia, Salemba Raya No. 6, Jakarta 10430, Indonesia
| |
Collapse
|
|
20
|
Bäcker HC, Galle SE, Maniglio M, Rosenwasser MP. Biomechanics of posterior shoulder instability - current knowledge and literature review. World J Orthop 2018; 9:245-254. [PMID: 30479971 PMCID: PMC6242730 DOI: 10.5312/wjo.v9.i11.245] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 08/31/2018] [Accepted: 10/10/2018] [Indexed: 02/06/2023] Open
Abstract
Posterior instability of the shoulder is a rare condition and represents about 10% of shoulder instability. It has become more frequently recognized in the last year, even though it is more difficult to diagnose than anterior shoulder instability. As this form of shoulder pathology is somewhat rare, biomechanical knowledge is limited. The purpose of our study was to perform an extensive literature search, including PubMed and Medline, and to give an overview of the current knowledge on the biomechanics of posterior shoulder instability. The PubMed/Medline databases were utilized, and all articles related to posterior shoulder instability and biomechanics were included to form a comprehensive compilation of current knowledge. A total of 93 articles were deemed relevant according to our inclusion and exclusion criteria. As expected with any newly acknowledged pathology, biomechanical studies on posterior shoulder instability remain limited in the literature. Current biomechanical models are performed in a static manner, which limits their translation for explaining a dynamic pathology. Newer models should incorporate dynamic stabilization of both the rotator cuff and scapulothoracic joint. There is a current lack of knowledge with regards to the pathomechanism of posterior shoulder instability, with no consensus on appropriate treatment regimens. Further investigation is therefore required at both basic science and clinical levels.
Collapse
Affiliation(s)
- Henrik Constantin Bäcker
- Department of Orthopedic Surgery, New York Presbyterian/Columbia University Medical Center, New York, NY 10032, United States
| | - Samuel E Galle
- Department of Orthopedic Surgery, New York Presbyterian/Columbia University Medical Center, New York, NY 10032, United States
| | - Mauro Maniglio
- Department of Orthopedics, HFR Cantonal Hospital of Fribourg, Fribourg 1752, Switzerland
| | - Melvin Paul Rosenwasser
- Department of Orthopedic Surgery, New York Presbyterian/Columbia University Medical Center, New York, NY 10032, United States
| |
Collapse
|
|
21
|
Alogayyel NS, Aldawodi MD, Ahmed B, Jawadi AH. Posterior shoulder dislocation in a 10-year-old child: Case report. Ann Med Surg (Lond) 2018; 33:32-35. [PMID: 30167300 PMCID: PMC6108073 DOI: 10.1016/j.amsu.2018.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Accepted: 08/13/2018] [Indexed: 11/30/2022] Open
Abstract
Introduction Shoulder dislocation is the most common type of all joints dislocations. It occurs when there is separation in the glenohumeral joint. Posterior dislocation accounts for less than 4% of all shoulder dislocations. In fact, it is misdiagnosed in 60–79% of the patients in the initial presentation. In children a posterior shoulder dislocation is usually caused by a congenital anomaly or in those who have ligamentous laxity. Traumatic posterior shoulder dislocation without fracture of the proximal humeral epiphysis in children is very rare, and only few cases have been reported. Case presentation This report presents a rare case of a 10-year-old child with a traumatic posterior shoulder dislocation without fracture. Discussion this patient present with a rare posterior dislocation, which is direct and without fracture. It does not present with a marked deformity and it is hard to detect without a complete physical examination and radiographic series. Conclusion Posterior shoulder dislocations are rare, and even more rare in children without fractures. It is easily missed and needs careful history taking, physical exam and correct x-ray view to reach the diagnosis.
Posterior dislocation is a rare entity. Traumatic posterior shoulder dislocation without fracture in children is very rare. These injuries are missed without a complete physical exam and a radiographic series. Non-operative treatment can be made with closed reduction. Immobilization for one to two weeks is recommended.
Collapse
Affiliation(s)
- Nawaf Sulaiman Alogayyel
- King Saud bin Abdulaziz University for Health Science, P.O. Box: 50577, Riyadh, 11533, Saudi Arabia
| | - Mohamed Dhafer Aldawodi
- King Saud bin Abdulaziz University for Health Science, P.O. Box: 50577, Riyadh, 11533, Saudi Arabia
| | - Bandar Ahmed
- Orthopedic Surgery, P.O. Box: 22490, Riyadh, 11426, Saudi Arabia
| | - Ayman H Jawadi
- Department of Pediatric Surgery, King Abdullah Specialized Children Hospital (KASCH), P.O. Box: 22490, Riyadh, 11426, Saudi Arabia
| |
Collapse
|
|
22
|
Watson L, Balster S, Warby SA, Sadi J, Hoy G, Pizzari T. A comprehensive rehabilitation program for posterior instability of the shoulder. J Hand Ther 2018. [PMID: 28641736 DOI: 10.1016/j.jht.2017.05.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Posterior shoulder instability is recognised as being less prevalent than anterior instability, however the diagnosis of this pathology is easily overlooked or missed and this may contribute to an underestimation of prevalence. Recently, there has been increasing recognition of this condition and consequently a greater requirement for knowledge of diagnostic procedures and treatment directions. Currently there is limited research into the conservative management of posterior instability, although it is recommended as first-line treatment prior to surgical review, particularly in those with an atraumatic instability mechanism. The aim of this paper is to outline a comprehensive rehabilitation program for the conservative management of posterior instability with a focus on scapular and humeral head control. The information provided includes extensive written information, flowcharts, figures and a table of management parameters that will provide therapists with adequate detail to replicate the program in the clinical setting.
Collapse
Affiliation(s)
- Lyn Watson
- Department of Rehabilitation, Nutrition and Sport, College of Science, Health and Engineering, La Trobe University, Bundoora, Victoria, Australia; LifeCare Prahran Sports Medicine Centre, Prahran, Victoria, Australia; Melbourne Orthopedic Group, Melbourne, Victoria, Australia
| | - Simon Balster
- LifeCare Prahran Sports Medicine Centre, Prahran, Victoria, Australia; Melbourne Orthopedic Group, Melbourne, Victoria, Australia
| | - Sarah Ann Warby
- Department of Rehabilitation, Nutrition and Sport, College of Science, Health and Engineering, La Trobe University, Bundoora, Victoria, Australia; LifeCare Prahran Sports Medicine Centre, Prahran, Victoria, Australia; Melbourne Orthopedic Group, Melbourne, Victoria, Australia
| | | | - Greg Hoy
- Melbourne Orthopedic Group, Melbourne, Victoria, Australia
| | - Tania Pizzari
- Department of Rehabilitation, Nutrition and Sport, College of Science, Health and Engineering, La Trobe University, Bundoora, Victoria, Australia.
| |
Collapse
|
|
23
|
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.
Collapse
|