2017 ISAKOS Biennial Congress ePoster #2014

 

The Outcome of Arthroscopic Treatment for Chronic Locked Posterior Shoulder Dislocation

Xuxu Chen, MD, Xi`An, Shaanxi CHINA
Hui Kang, Prof., Xi'an, Shaanxi CHINA
Tao Wang, MD, Xi An CHINA
Jian Li, MD, Xi'an, Shaanxi CHINA

Hong-Hui Hospital, Xi`an Jiaotong University College of Medicine, Xi`an, Shaanxi, CHINA

FDA Status Not Applicable

Summary

It is a retrospective study on the outcome of arthroscopic treatment for chronic locked posterior shoulder dislocation.

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Abstract

Background

Chronic locked posterior shoulder dislocation is considered to be a rare injury accounting for only 2-5% of all shoulder dislocations. Despite its scarce appearance in daily clinical practice, posterior shoulder dislocation is of significant diagnostic and therapeutic interest because of its damage on shoulder function and its high incidence of missed initial diagnosis. It is still a challenge for surgeons to treat chronic locked posterior shoulder dislocation. The different treatment options, such as closed reduction, transfer of the subscapularis tendon, transfer of the lesser tuberosity, rotational osteotomy of the humerus, allograft reconstruction, and arthroplasty, depend on the duration of the dislocation, the extend of the damage of the articular surface and the whole humeral head, the condition of the glenoid and the general health of the patient.
Subjects and Methods:
We retrospectively reviewed 6 patients who got a chronic locked posterior shoulder dislocation. There were 4 males and 2 females, with an average age of 57.1 years (44-69). Two left shoulders and four right ones were involved. All six patients underwent an arthroscopic reduction and suture repair of the posterior labrum-ligament-capsular complex (reverse Bankart repairing). All operations were performed by one same surgeon. All patients were reviewed in the clinic. The shoulder Constant-Murley score, visual analogue scale (VAS) for pain and the Oxford Shoulder Instability Score were evaluated before and after surgery. Ranges of motion of both the injuried shoulder and the contralateral one were measured and compared.

Results

The mean follow-up time was 21.7 months. At the follow-up ending time, there was no patient who got recurrence dislocation. At 18 months after surgery, the VAS for pain significantly decreased from 4.3±1.7 before surgery to 0.8±0.3 after surgery(P=0.014). The shoulder Constant-Murley score significantly from 43.2±5.6 before surgery to 88.0±11.5 after surgery(P<0.001). The Oxford score significantly improved from 37.8±5.0 before surgery to 13.5±2.3 after surgery(P<0.001). The exterior rotation at 0° abduction of the injuried shoulder was 30.8±8.6°, which was significantly lower than 41.2±4.4° of the contralateral one(P=0.002). There were no significant difference in ranges of motion in other directions between the injured and contralateral shoulders.

Conclusions

Arthroscopic reduction and suture repair of the posterior labrum-ligament-capsular complex is effective to treat locked posterior shoulder dislocations.