Surgical Treatment of Locked Posterior Shoulder Dislocation

Introduction Locked posterior dislocation of the shoulder is rare and difficult to treat. These injuries commonly involve impression fractures of the humeral articular surface. Treatment depends on the extent of the humeral head defect, and various methods can be used to restore its spherical shape. We conducted a retrospective study of five patients who underwent allograft or hemiarthroplasty for humeral head impression fracture after locked posterior shoulder dislocation. Methods Between 2001 and 2006, five patients with an average age of 41.6 years (range, 26-58 years) were treated at our institution after locked posterior shoulder dislocation. The delay between injury and diagnosis ranged from 7 days to 4 months. All patients had anteromedial impression fractures, and one had additional three-part proximal humeral fracture. The injury was caused by trauma in four patients and by epileptic seizure in one patient. Open reduction with femoral head allograft for reconstruction of the defect was performed in three cases, and hemiarthroplasty was performed in two cases. Results At a mean follow-up time of 49.8 months (range, 28-62 months), the result was rated excellent for three patients, good for one patient, and fair for one patient. The mean Constant-Murley score was 87.4 points (range, 76-93 points). There were no cases of redislocation, and only one patient had shoulder cuff tendinitis pain after hemiarthroplasty. Conclusion Both anatomical humeral head reconstruction with allograft and hemiarthroplasty are effective methods of restoring shoulder function and stability after locked posterior shoulder dislocation.

並列關鍵字

locked posterior shoulder dislocation ； impression fracture ； allograft ； hemiarthroplasty ； epileptic seizure

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