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A novel modified McLaughlin surgery for treating locked chronic posterior shoulder dislocation
Fei Xiong1,2, Qin Yin1, Jian Wang1
1Department of Orthopaedics, Wuxi 9Th People's Hospital Affiliated to Soochow University, NO.999 Liangxi Road, Wuxi, China.
BMC Musculoskeletal Disorders
|February 11, 2023
Summary
A modified McLaughlin procedure effectively treated chronic posterior shoulder dislocations with reverse Hill-Sachs lesions. This technique improved shoulder stability, reduced pain, and restored function, offering a viable surgical option for this rare injury.
Area of Science:
- Orthopaedics
- Surgical Innovation
Background:
- Posterior shoulder dislocation is an uncommon injury (2%-4% of dislocations), often missed or misdiagnosed.
- Chronic posterior shoulder dislocation with reverse Hill-Sachs lesions presents significant treatment challenges, particularly for humeral defects.
- Existing surgical options include tendon transfers, osteotomies, and bone grafts, with shoulder replacement as a last resort, sometimes yielding unsatisfactory results.
Purpose of the Study:
- To describe and evaluate a novel modified McLaughlin procedure for treating locked chronic posterior shoulder dislocation.
- To assess the functional outcomes and efficacy of this surgical technique in patients with associated reverse Hill-Sachs lesions.
Main Methods:
- The study included five patients with locked chronic posterior shoulder dislocation and reverse Hill-Sachs lesions (30%-40% humeral head compression).
- A modified McLaughlin procedure involving open reduction, transfer of the partial lesser tuberosity with artificial bone to repair defects, and fixation with lag screws and sutures was performed.
- Functional outcomes were assessed using the Constant-Murley score (CMS), range of motion, and complication monitoring.
Main Results:
- Mean CMS significantly improved from 46.0 preoperatively to 85.8 postoperatively (p=0.001) after an average follow-up of 19.8 months.
- All patients achieved shoulder stability, experienced no pain or activity limitation, and reported satisfaction with the surgical outcome.
- No complications were reported in the follow-up period.
Conclusions:
- Transferring the partial lesser tuberosity with artificial bone, secured by lag screws and sutures, effectively repairs reverse Hill-Sachs lesions.
- This modified McLaughlin procedure provides shoulder stability, pain relief, and good functional recovery for patients with locked chronic posterior shoulder dislocation and humeral head defects.
