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Traumatic posterior shoulder dislocation: a case with modification of Gerber procedure for humeral head reconstruction at 10-year follow-up

Abstract

We report a case of acute traumatic posterior shoulder dislocation in a 41-year-old patient, which we treated surgically by a modification of the procedure described by Gerber for humeral head reconstruction in such cases. The diagnosis was confirmed by CT scan, which also helped us to assess the size of the antero-medial humeral head defect or impaction secondary to the dislocation; the size of this defect being a determinant element for the indication. Because the shoulder was unstable after closed reduction and almost 50% of the humeral head was impacted, we carried out a surgical treatment using an original technique as mentioned above. Radiologic and surgical features of acute traumatic posterior shoulder dislocation are discussed with special emphasis on diagnosis, indications and surgical aspects of this rare lesion, which represent 2–4% of acute traumatic shoulder dislocations.

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References

  1. 1.

    Arndt JH, Sears AD (1965) Posterior dislocation of the shoulder. AJR Am J Roentgenol 94:639–645

    CAS  Google Scholar 

  2. 2.

    Bloom MH, Obata WG (1967) Diagnosis of posterior dislocation of the shoulder with use of Velpeau axillary and angle up roentgenographic views. J Bone Joint Surg Am 49:943–949

    PubMed  CAS  Google Scholar 

  3. 3.

    Cisternino SJ, Rogers LF, Stufflebam BC, Kruglik GD (1978) The trough line: a radiographic sign of posterior shoulder dislocation. AJR Am J Roentgenol 130:951–954

    PubMed  CAS  Google Scholar 

  4. 4.

    Constant CR, Murley AH (1987) A clinical method of functional assessment of the shoulder. Clin Orthop 214:160–164

    PubMed  Google Scholar 

  5. 5.

    Dubousset J (1967) Luxations postérieures de l’épaule. Rev Chir Orthop 53:65–85

    PubMed  CAS  Google Scholar 

  6. 6.

    Finkelstein JA, Waddell JP, O’Driscoll SW, Vincent G (1995) Acute posterior fracture dislocations of the shoulder treated with the Neer modification of the McLaughlin procedure. J Orthop Trauma 9:190–193

    PubMed  CAS  Article  Google Scholar 

  7. 7.

    Gerber C (1988) Les instabilités de l’épaule. In: Duparc J (ed) Cahiers d’enseignement de la SOFCOT No. 33. Expansion Scientifique Française, Paris, pp 51–74

    Google Scholar 

  8. 8.

    Gerber C (1991) L’instabilité postérieure de l’épaule. In: Duparc J (ed) Cahiers d’enseignement de la SOFCOT No. 40. Conférences d’enseignement 1991. Expansion Scientifique Francaise, Paris, pp 223–245

    Google Scholar 

  9. 9.

    Gerber C, Lambert S (1996) Allograft reconstruction of segmental defects of the humeral head for the treatment of chronic locked posterior dislocation of the shoulder. J Bone Joint Surg Am 78:376–382

    PubMed  CAS  Google Scholar 

  10. 10.

    Gerber C, Pennington SD, Yian EH, Pfirrmann CAW, Werner CML, Zumstein MA (2006) Lesser tuberosity osteotomy for total shoulder arthroplasty. J Bone Joint Surg Am 87:1739–1745

    Article  Google Scholar 

  11. 11.

    Hawkins RJ, Neer CSII (1987) Locked posterior dislocation of the shoulder. J Bone Joint Surg Am 69:9–18

    PubMed  CAS  Google Scholar 

  12. 12.

    Kaar TK, Wirth MA, Rockwood CA (1999) Missed posterior fracture-dislocation of the humeral head. A case report with a fifteen-year follow-up after delayed open reduction and internal fixation. J Bone Joint Surg Am 81:708–710

    PubMed  CAS  Google Scholar 

  13. 13.

    Mansat M, Devallet P (1988) Luxations et subluxations postérieures de l’épaule. Rev Chir Orthop (Suppl II) 74:257–259

    Google Scholar 

  14. 14.

    McLaughlin HL (1952) Posterior dislocation of the shoulder. J Bone Joint Surg Am 34:584–590

    Google Scholar 

  15. 15.

    Picard F (1993) Technique du score de Constant pour l’évaluation fonctionnelle de l’épaule. In: Les journées Lyonnaises de l’épaule. Lyon, 1–3 Avril 1993

  16. 16.

    Picard F, Saragaglia D, Montbarbon E, Tourné Y, Thony YF, Charbel A (1998) Conséquences anatomo-cliniques de la section verticale du muscle sub-scapulaire dans l’intervention de Latarjet. Rev Chir Orthop 84:217–223

    PubMed  CAS  Google Scholar 

  17. 17.

    Randelli M (1988) Posterior fracture-dislocations of the shoulder. In: 2nd Congress of the European Society of Shoulder and Elbow Surgery. Berne, 1–2 October 1988

  18. 18.

    Richards RH, Clarke NM (1989) Locked posterior fracture-dislocation of the shoulder. Injury 20:297–300

    PubMed  CAS  Article  Google Scholar 

  19. 19.

    Samilson RL, Miller E (1964) Posterior dislocation of the shoulder. Clin Orthop 32:69–86

    PubMed  CAS  Google Scholar 

  20. 20.

    Stableforth PG, Sarangi PP (1992) Posterior fracture-dislocation of the shoulder. J Bone Joint Surg Br 74:579–584

    PubMed  CAS  Google Scholar 

  21. 21.

    Swamy G, Schemitsch EH (1998) Humeral head fracture-dislocation: case report and review of the literature. J Trauma 44:377–380

    PubMed  CAS  Article  Google Scholar 

  22. 22.

    Vandenbussche E, Augereau B (1994) Les instabilités postérieures de l’épaule. In: Duparc J (ed) Cahiers d’enseignement de la SOFCOT No. 49. Instabilité chronique de l’épaule. Expansion Scientifique Française, Paris, pp 75–87

    Google Scholar 

  23. 23.

    Vandenbussche E, Augereau B (1996) Luxations et luxations-fractures postérieures. In: Duparc J (ed) Cahiers d’enseignement de la SOFCOT No. 56. Traumatismes récents de l’épaule. Expansion Scientifique Française, Paris, pp 238–245

    Google Scholar 

  24. 24.

    Vastamaki M, Solonen KA (1980) Posterior dislocation and fracture-dislocation of the shoulder. Acta Orthop Scand 51:479–484

    PubMed  CAS  Article  Google Scholar 

  25. 25.

    Vichard Ph, Arnould D (1981) Les luxations-fractures postérieures de l’épaule. Etude anatomo-pathologique et thérapeutique à propos de 11 observations. Rev Chir Orthop 67:71–77

    PubMed  CAS  Google Scholar 

  26. 26.

    Vichard Ph (1988) Luxations-fractures de l’épaule. In: Duparc J (ed) Cahiers d’enseignement de la SOFCOT No. 31. Conférences d’enseignement 1988. Expansion Scientifique Française, Paris, pp 179–193

    Google Scholar 

  27. 27.

    Walch G, Boileau P, Martin B, Dejour H (1990) Luxations et fractures-luxations postérieures invétérées de l’épaule. A propos de 30 cas. Rev Chir Orthop 76:546–558

    PubMed  CAS  Google Scholar 

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No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

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Correspondence to Ali Chamseddine.

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Chamseddine, A., Jawish, R., Hamdan, H. et al. Traumatic posterior shoulder dislocation: a case with modification of Gerber procedure for humeral head reconstruction at 10-year follow-up. Eur J Orthop Surg Traumatol 19, 87–92 (2009). https://doi.org/10.1007/s00590-008-0374-x

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Keywords

  • Posterior shoulder dislocation
  • Diagnosis
  • Surgery
  • Transplantation