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Updated: Feb 17, 2026
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Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
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[Undetected traumatic posterior glenohumeral dislocation]
1Servicio de Traumatología del Hospital General Regional Núm. 2 del Instituto Mexicano del Seguro Social (IMSS). Ciudad de México. México.
Acta Ortopedica Mexicana
|December 8, 2017
Summary
Traumatic posterior glenohumeral dislocation (TPGHD) is rare and often misdiagnosed. Early recognition and treatment, even with delayed diagnosis, can lead to favorable outcomes if the reverse Hill-Sachs lesion is minor.
Area of Science:
- Orthopedic Surgery
- Radiology
- Sports Medicine
Background:
- Traumatic posterior glenohumeral dislocation (TPGHD) is an uncommon injury, representing 1-4% of all glenohumeral dislocations.
- Diagnosis is frequently delayed or missed due to its rarity and subtle clinical presentation, with missed diagnosis rates reported between 60-79%.
Observation:
- Two cases of TPGHD are presented: one diagnosed in the 4th week and another after 8 months.
- Both patients had reverse Hill-Sachs lesions (one <25%, the other 25%) and underwent surgical reduction with favorable functional recovery (UCLA scores of 32 and 29, respectively).
Findings:
- Delayed diagnosis and treatment of TPGHD can still result in favorable outcomes if the associated reverse Hill-Sachs injury is 25% or less.
- Key diagnostic elements include considering the injury mechanism, physical examination findings (arm in internal rotation), and specific radiographic views (true AP, scapular Y view).
Implications:
- Emphasizes the importance of maintaining a high index of suspicion for TPGHD in patients with unexplained shoulder deficits, particularly those involving external rotation, flexion, and abduction.
- Highlights the need for thorough radiographic evaluation and clinical assessment to avoid diagnostic delays and ensure appropriate management of TPGHD.
