Surgical treatment of chronic locked posterior dislocation of the shoulder

Abstract

Objective To evaluate the results of management of chronic locked posterior dislocation of the shoulder by surgical reduction with bone graft to restore joint surface of the humeral head. Methods From March 2002 to April 2008, 18 patients were treated for chronic locked posterior dislocation of the shoulder. They all were treated surgically to reduce the shoulder and restore humeral head joint surface with large bone graft. Mean time between trauma and surgery was 5 months. Preoperative CT scan confirmed shoulder posterior dislocation and a reverae Hill-Sachs lesion in all 18 patients, 8 of them with bone loss from 20% to 25% and 10 within 25% to 45%. scored for the Constant score (CS) and UCLA score at follow up. Results Postoperatively the patients were followed up for 1 to 4 years, with an average of 2.6 years. Shoulder function was evaluated using the Constant score and UCLA score. According Constant scoring 7 cases were rated as excellent, 9 cases as good, 1 case as fair and 1 case as poor. The average rate of excellent and good results was 88.8%. Only 1 case had stiff shoulder, but no recurrent dislocation occurred. UCLA score was 35 for the highest and 13 for the lowest, the mean being 30. Conclusion Open reduction and bone grafting resulted in good midterm results for the patients with traumatic chronic locked posterior dislocation of the shoulder. Key words: Shoulder dislocation; Wounds and injuries; Bone transplantation; Surgical procedures;  operative