Posterior shoulder fracture-dislocation: A systematic review of the literature and current aspects of management.
10.1016/j.cjtee.2020.09.001
- Author:
Georgios PAPAROIDAMIS
1
,
2
;
Efthymios ILIOPOULOS
3
;
A Ali NARVANI
1
,
4
;
Ofer LEVY
5
;
Eleftherios TSIRIDIS
6
,
7
;
Ioannis POLYZOIS
1
,
8
,
9
Author Information
1. The Rowley Bristow Unit, Ashford & St Peter's Hospitals, NHS Foundation Trust, Chertsey, Surrey, United Kingdom
2. Academic Orthopaedic Department, Papageorgiou General Hospital, Faculty of Health Sciences, Medical School, Aristotle University of Thessaloniki, and CORE Lab, CIRI - AUTh, Thessaloniki, Greece.
3. The Rowley Bristow Unit, Ashford & St Peter's Hospitals, NHS Foundation Trust, Chertsey, Surrey, United Kingdom.
4. Shoulder and Elbow Centre - Reading Shoulder Unit, United Kingdom.
5. Shoulder and Elbow Centre - Reading Shoulder Unit, United Kingdom.
6. Academic Orthopaedic Department, Papageorgiou General Hospital, Faculty of Health Sciences, Medical School, Aristotle University of Thessaloniki, and CORE Lab, CIRI - AUTh, Thessaloniki, Greece
7. International Center for Arthroplasty & Robotic Orthopaedic Surgery (ICAROS), European Interbalkan Medical Center, Thessaloniki, Greece.
8. Shoulder and Elbow Centre - Reading Shoulder Unit, United Kingdom
9. Surrey Orthopaedic Clinic, United Kingdom. Electronic address: polyzois77@gmail.com.
- Publication Type:Journal Article
- Keywords:
Fracture-dislocation;
Posterior dislocation;
Shoulder dislocation;
Shoulder injury;
Treatment algorithm
- From:
Chinese Journal of Traumatology
2021;24(1):18-24
- CountryChina
- Language:English
-
Abstract:
PURPOSE:Posterior fracture-dislocation of shoulder is an infrequent traumatic event; however, most orthopaedic surgeons may face the challenge of treating it. The aim of this study is to review and summarise systematically the current principles of the management of this complex injury, and create a treatment algorithm.
METHODS:Both PubMed and Scopus Databases were systematically searched for the terms "posterior shoulder fracture-dislocation" or "posterior glenohumeral fracture-dislocation" or "posterior glenoid fracture-dislocation" for articles written in English and published in the last decade.
RESULTS:A total of 900 articles were identified, of which 13 were retained for analysis. A total of 153 patients (161 shoulders) were identified. These patients were treated either with open reduction and internal fixation, modified McLaughlin procedure, allograft/autograft humeral head reconstruction or shoulder arthroplasty. The mean age was 40.15 years. The mean postoperative Constant score in cases treated by open reduction and internal fixation was 86.45, whereas by bone graft was 84.18. Further, the mean postoperative Constant score was between 79.6 and 67.1 in those that were managed by modified McLaughlin and arthroplasty procedure, respectively.
CONCLUSION:The management of posterior shoulder fracture-dislocation may be challenging, and the best surgical option depends on many variables such as the chronicity of the injury, the presence of a fracture at the level of the surgical neck or tuberosities and the extend of the Hill-Sachs lesion if any. A treatment algorithm is proposed, based on the current literature in an effort to create a consensus for these injuries. For the acute shoulder fracture-dislocations, an open reduction should be performed. For the chronic fracture/dislocations in the elderly low-demand patients, conservative treatment should be performed. For the rest of the patients, depending on the severity of the Hill-Sachs lesion different surgical options are available such as the McLaughlin technique, the use of an allograft, osteotomy or arthroplasty.
