Treatment of unusual locked posterior fracture–dislocation of the shoulder: a case series
Background Locked posterior fracture-dislocation of the shoulder (LPFDS) is a very rare injury that occurs predominantly in young patients following high-energy trauma. The long-term outcome of the treatment of this injury is often poor. This study sought to present the characteristics of injury, di...
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| Format: | Article |
| Language: | English |
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Korean Shoulder and Elbow Society
2020-12-01
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| Series: | Clinics in Shoulder and Elbow |
| Subjects: | |
| Online Access: | http://www.cisejournal.org/upload/pdf/cise-2020-00255.pdf |
| _version_ | 1827362901521858560 |
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| author | Ho Yeon Park Seok Jung Kim Yoo Joon Sur Jae Woong Jung Chae-gwan Kong |
| author_facet | Ho Yeon Park Seok Jung Kim Yoo Joon Sur Jae Woong Jung Chae-gwan Kong |
| author_sort | Ho Yeon Park |
| collection | DOAJ |
| description | Background Locked posterior fracture-dislocation of the shoulder (LPFDS) is a very rare injury that occurs predominantly in young patients following high-energy trauma. The long-term outcome of the treatment of this injury is often poor. This study sought to present the characteristics of injury, discuss the pathological anatomy, and to report the treatment outcomes of our case series. Methods Between January 2012 and May 2018, a total of 234 patients who underwent surgical treatment for proximal humerus fractures were reviewed. Among them, six patients (mean age, 54.7 years; range, 35–76 years) with LPFDS were included in this study. Four patients were treated with open reduction and internal fixation (ORIF) with locking plates, one with hemiarthroplasty, and one with reverse total shoulder arthroplasty. Clinical results were evaluated by Constant, American Shoulder and Elbow Surgeons (ASES), and visual analog scale (VAS) scores and radiologic evaluation was conducted using follow-up radiographs. Results The mean length of follow-up was 26.2 months (range, 12–54). The mean Constant, ASES, and VAS scores were 66.7, 65.5, and 2.2, respectively. Four patients who underwent ORIF achieved bony union, but avascular necrosis (AVN) of the humeral head was observed in two patients. No complications were observed in the patients who underwent arthroplasty surgery until final follow-up. Conclusions In the treatment of LPFDS, replacement arthroplasty can produce predictable results. The approach of ORIF may be considered as a first choice of treatment in young patients but is sometimes correlated with postoperative complications such as AVN and the functional outcomes may be unpredictable. Therefore, patients should undergo careful diagnosis and treatment of this type of injury. |
| first_indexed | 2024-03-08T07:37:12Z |
| format | Article |
| id | doaj.art-760a6589a8db4be9abcbdaba32dcfe67 |
| institution | Directory Open Access Journal |
| issn | 2288-8721 |
| language | English |
| last_indexed | 2024-03-08T07:37:12Z |
| publishDate | 2020-12-01 |
| publisher | Korean Shoulder and Elbow Society |
| record_format | Article |
| series | Clinics in Shoulder and Elbow |
| spelling | doaj.art-760a6589a8db4be9abcbdaba32dcfe672024-02-02T18:36:41ZengKorean Shoulder and Elbow SocietyClinics in Shoulder and Elbow2288-87212020-12-0123419019610.5397/cise.2020.00255785Treatment of unusual locked posterior fracture–dislocation of the shoulder: a case seriesHo Yeon Park0Seok Jung Kim1Yoo Joon Sur2Jae Woong Jung3Chae-gwan Kong4 Department of Orthopedic Surgery, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea Department of Orthopedic Surgery, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea Department of Orthopedic Surgery, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea Department of Orthopedic Surgery, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea Department of Orthopedic Surgery, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, KoreaBackground Locked posterior fracture-dislocation of the shoulder (LPFDS) is a very rare injury that occurs predominantly in young patients following high-energy trauma. The long-term outcome of the treatment of this injury is often poor. This study sought to present the characteristics of injury, discuss the pathological anatomy, and to report the treatment outcomes of our case series. Methods Between January 2012 and May 2018, a total of 234 patients who underwent surgical treatment for proximal humerus fractures were reviewed. Among them, six patients (mean age, 54.7 years; range, 35–76 years) with LPFDS were included in this study. Four patients were treated with open reduction and internal fixation (ORIF) with locking plates, one with hemiarthroplasty, and one with reverse total shoulder arthroplasty. Clinical results were evaluated by Constant, American Shoulder and Elbow Surgeons (ASES), and visual analog scale (VAS) scores and radiologic evaluation was conducted using follow-up radiographs. Results The mean length of follow-up was 26.2 months (range, 12–54). The mean Constant, ASES, and VAS scores were 66.7, 65.5, and 2.2, respectively. Four patients who underwent ORIF achieved bony union, but avascular necrosis (AVN) of the humeral head was observed in two patients. No complications were observed in the patients who underwent arthroplasty surgery until final follow-up. Conclusions In the treatment of LPFDS, replacement arthroplasty can produce predictable results. The approach of ORIF may be considered as a first choice of treatment in young patients but is sometimes correlated with postoperative complications such as AVN and the functional outcomes may be unpredictable. Therefore, patients should undergo careful diagnosis and treatment of this type of injury.http://www.cisejournal.org/upload/pdf/cise-2020-00255.pdfshoulderhumerusfracture dislocationposterior |
| spellingShingle | Ho Yeon Park Seok Jung Kim Yoo Joon Sur Jae Woong Jung Chae-gwan Kong Treatment of unusual locked posterior fracture–dislocation of the shoulder: a case series Clinics in Shoulder and Elbow shoulder humerus fracture dislocation posterior |
| title | Treatment of unusual locked posterior fracture–dislocation of the shoulder: a case series |
| title_full | Treatment of unusual locked posterior fracture–dislocation of the shoulder: a case series |
| title_fullStr | Treatment of unusual locked posterior fracture–dislocation of the shoulder: a case series |
| title_full_unstemmed | Treatment of unusual locked posterior fracture–dislocation of the shoulder: a case series |
| title_short | Treatment of unusual locked posterior fracture–dislocation of the shoulder: a case series |
| title_sort | treatment of unusual locked posterior fracture dislocation of the shoulder a case series |
| topic | shoulder humerus fracture dislocation posterior |
| url | http://www.cisejournal.org/upload/pdf/cise-2020-00255.pdf |
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