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Management and Prognostic Factors for Delayed Reconstruction of Neglected Posterior Shoulder Fracture-Dislocation
Taner Bekmezci1, Egemen Altan2
1Department of Orthopaedics and Traumatology, Liv Hospital, Bahcesehir University, Istanbul, Turkey.
Archives of Trauma Research
|February 6, 2016
Summary
Posterior shoulder fracture-dislocations are rare and often misdiagnosed. Successful surgical reconstruction of the humeral head is possible even in neglected cases with malunion.
Area of Science:
- Orthopedic Surgery
- Traumatology
Background:
- Posterior shoulder fracture-dislocations are infrequent injuries, with a high rate of misdiagnosis (50%-80%).
- Traditional treatments like tendon or tuberosity transfer are insufficient for large lesions, compromising joint stability.
Observation:
- A case report details a 54-year-old male with a neglected posterior shoulder fracture-dislocation.
- The patient presented with a reverse Hill-Sachs lesion affecting 40% of the humeral head's articular surface.
- The depressed, malunited osteochondral fragment was surgically elevated and fixated.
Findings:
- Glenohumeral joint reduction and humeral head reconstruction are feasible in neglected posterior shoulder fracture-dislocations.
- Successful reconstruction depends on the fragment's sphericity, absence of avascular necrosis on CT, and occurrence of malunion.
Implications:
- This case demonstrates a viable surgical approach for complex posterior shoulder injuries.
- Long-term follow-up is crucial to monitor for potential complications in patients undergoing such reconstructions.
