Περίληψη:
Several surgical techniques have been described for the treatment of
posterior shoulder dislocation depending on the time elapsed between
injury and surgery and the size of the humeral head impression fracture.
When the bone defect is between 25% and 50% of the articular surface
of the head, the procedures of choice are autologous bone graft or
allograft or subscapularis tendon or lesser tuberosity transfer. In
neglected cases in which patients undergo surgery more than 3 weeks
after injury, no standard accepted treatment for this injury exists.
This article presents a modification of the McLaughlin technique for
patients with neglected locked posterior dislocation of the shoulder.
Using this technique, the shape of the humeral head was nearly restored
with impaction of morselized bone allograft; two suture anchors were
inserted into the defect, and the lesser tuberosity with the attached
subscapularis tendon was transferred into the defect and secured with
sutures. Postoperative rehabilitation included immobilization of the
shoulder with an external rotation brace for 6 weeks followed by
progressive passive, active-assisted, and active range of motion and
rotator cuff strengthening exercises for another 6 weeks. This technique
resulted in pain-free range of motion, a stable shoulder, and good joint
congruency.
Συγγραφείς:
Kokkalis, Zinon T.
Mavrogenis, Andreas F.
Ballas, Efstathios G.
and Papanastasiou, John
Papagelopoulos, Panayiotis J.
