Differential Treatment of Posterior Shoulder Dislocation

S.S. Strafun, V.M. Lomko

Abstract


Introduction. Treatment of patients with posterior dislocation of the shoulder is a complex problem, which is far from being resolved. This is possible if there is a maximum recovery of damaged structures and differentiated approach to the reconstructive interventions in this pathology, depending on the age of defect and the size of damage to the head.
Objective. To analyze the outcomes of surgical treatment based on the time of injury and the size of the defect of the humeral head.
Materials and methods. The material to work was the results of examination and surgical treatment of 30 patients with posterior dislocation of the shoulder aged 20 to 70 years (mean age 39.5 years) who were treated in the clinic of microsurgery and reconstructive surgery of the upper extremities of the SI «ITO of the NAMS of Ukraine». There were 26 men, 4 women. 15 patients (50 %) had damage of the right shoulder joint, 12 (40 %) — of the left and 3 (10 %) — bilateral. Limitation of damage ranged from 6 days to 53 months (average duration of 193 days). Treatment of patients was presented, depending on the timing of the injury and the nature of the damage.
Results and discussion. The results depended on the date of treatment initiation and the severity of combined injuries. The greatest number of excellent and good results (7; 23.6 %) was obtained in the treatment of recent cases, up to 1 month, while for the reduction of the static stabilizers of the shoulder joint we have used earlier graduated active rehabilitation, 3 weeks after surgery. It was possible to achieve the certain range of motions (81 points according to Constant-Murley score) by the end of rehabilitation.
Conclusions. The successful treatment of patients with posterior dislocation of the shoulder is possible in the maximum recovery of all damaged structures and differentiated approach to the reconstructive surgeries in this pathology, depending on the age of the injury and size of the damage to the head.


Keywords


posterior shoulder dislocation; depressed fracture; reverse Hill-Sachs lesion; open reduction of dislocation; subpectoral tenodesis of the long head of the biceps tendon; fracture of the posterior edge of the articular surface of the scapula

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DOI: https://doi.org/10.22141/1608-1706.1.17.2016.74168

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