Differential Treatment of Posterior Shoulder Dislocation
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.
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Detenbeck L.C. Posterior dislocations of the shoulder // J. Trauma. 1972; 12(3): 183-92.
Matsen F.A.III, Titelman R.M., Lippitt S.B. et al. Glenohumeral instability / Ed. by Rockwood C.A. Jr, Matsen F.A. III, Wirth M.A. et al. // The shoulder, vol. 2, 3rd edition. — Philadelphia: Saunders, 2004. — P. 655-794.
Funk Lennard, Owen J.M., Bonner Clare. Clinical assessment of posterior shoulder joint instability // Journal of Arthroscopy and Jointsurgery. — 2014. — 1.
Robinson C.M., Akhtar A., Mitchell M. et al. Complex posterior fracture-dislocation of the shoulder. Epidemiology, injury patterns, and results of operative treatment // J. Bone Joint Surg. Am. — 2007. — 89(7). — 1454-66.
Robinson C.M., Aderinto J. Posterior shoulder dislocations and fracture-dislocations // J. Bone Joint Surg. Am. — 2005. — 87(3). — 639-50.
Finelli P.F., Cardi J.K. Seizureas a cause of fracture // Neurology. — 1989. — 39(6). — 858-60.
Hepburn D.A., Steel J.M., Frier B.M. Hypoglycemic convulsions cause serious musculo skeletal injuries in patients with IDDM // Diabetes Care. — 1989. — 12(1). — 32-4.
Niazi T.B., Lemon J.G. Posterior dislocation of the shoulder dueto a hypocalcaemic fit // Injury. — 1990. — 21(6). — 407.
Ozer H., Baltaci G., Selek H. et al. Opposite-direction bilateral fracture dislocation of the shoulder safteran electricshock // Arch. Orthop. Trauma Surg. — 2005. — 125(7). — 499-502.
Iosifidis M.I., Giannoulis I., Traios S. et al. Simultaneous bilateral posterior dislocation of the shoulder: diagnostic problems and management. A case report // Knee Surg. Sports Traumatol. Arthrosc. — 2006. — 14(8). — 766-70.
Roberts A., Wickstrom J. Prognosis of posterior dislocation of the shoulder // Acta Orthop. Sc. — 1971. — 42(4). — 328-37.
Tan A.H. Missed posterior fracture-dislocation of the humeral head followingan electrocution injury to the arm // Singapore Med. J. — 2005. — 46(4). — 189-92.
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