Clinical Research
Diagnosis and treatment of posterior shoulder dislocation combined with reverse Hill-Sachs lesion
Li Chunpu, Chen Jinli, Qi Chao, Li Qicai
Published 2023-02-15
Cite as Chin J Orthop Trauma, 2023, 25(2): 175-179. DOI: 10.3760/cma.j.cn115530-20221018-00518
Abstract
ObjectiveTo explore the diagnosis and treatment of posterior shoulder dislocation combined with reverse Hill-Sachs lesion.
MethodsTwo male patients were treated at Department of Joint Surgery, Affiliated Hospital of Qingdao University for posterior shoulder dislocation combined with reverse Hill-Sachs lesion from August to November 2022. Case 1 was a 46-year-old man, admitted 1 day after right should injury, and case 2 a 57-year-old man, admitted 2 days after right should injury. The injury was caused by electric shock in both, and their fractures were fresh with an injury area>50%. After anatomical reduction of the collapsed humeral head via the pectoralis major deltoid approach, an artificial bone was implanted and fixated with countersunk screws in both cases to reduce the shoulder joint. The Constant-Murley scale and visual analogue scale (VAS) were used to evaluate the functional recovery of the shoulder and pain after treatment.
ResultsNo such perioperative complications as incision infection, brachial plexus injury or vascular injury was observed in either of the 2 patients. Reexamination 3 months after surgery showed in case 1: 110° of shoulder anterior flexion, 90° of shoulder abduction, 30° of external rotation (neutral position), 70° of internal rotation (neutral position), 70 points of Constant-Murley shoulder score, and 3 points of VAS pain score; in case 2: 130° of shoulder anterior flexion, 120° of shoulder abduction, 50° of external rotation (neutral position), 80° of internal rotation (neutral position), 70 points of Constant-Murley shoulder score, and 2 points of VAS pain score.
ConclusionFor patients with posterior shoulder dislocation complicated with reverse Hill-Sachs lesion and humeral head collapse greater than 50%, open reduction and screw internal fixation combined with artificial bone grafting can achieve good short-term curative efficacy.
Key words:
Shoulder joint; Shoulder dislocation; Wounds and injuries; Reverse Hill-Sachs lesion
Contributor Information
Li Chunpu
Department of Clinical Medicine, Qingdao University, Qingdao 266000, China
Department of Sports Medicine, Affiliated Hospital of Qingdao University, Qingdao 266000, China
Chen Jinli
Department of Sports Medicine, Affiliated Hospital of Qingdao University, Qingdao 266000, China
Qi Chao
Department of Sports Medicine, Affiliated Hospital of Qingdao University, Qingdao 266000, China
Li Qicai
Department of Joint Surgery, Affiliated Hospital of Qingdao University, Qingdao 266000, China