Locked Posterior Shoulder Dislocation Associated With Isolated Fractures of the Lesser Tuberosity: A Clinical Study of 22 Cases With a Minimum of 2-Year Follow-up

Abstract

Objectives: To evaluate the clinical and radiographic outcomes of 2-part lesser tuberosity fracture with a locked posterior dislocation.

Design: Retrospective case series study.

Setting: Beijing Jishuitan Hospital ("first-level teaching hospital").

Patients/participants: Between April 2003 and June 2010, 29 patients received surgical treatment for 2-part lesser tuberosity fractures with an associated locked posterior shoulder dislocation. At the final follow-up, 22 of these patients were available for evaluation.

Intervention: Open reduction and internal fixation.

Main outcome measurements: The shoulder range of motion and visual analog scale pain score were recorded. The postoperative outcomes were evaluated using Score of University of California in Los Angeles (UCLA), Constant, and American Shoulder and Elbow Surgeons (ASES) Scale score. The degree of humeral head necrosis was analyzed according to plain radiographs. The effects of patients' age, dominant-side involvement, as well as time from initial injury to surgery (TFIS) on clinical outcomes and the degree of humeral head necrosis were evaluated.

Results: There were 21 men and 1 woman. The average age was 41.7 years. The dominant side was involved in 12 of 22 cases (54.5%). The average TFIS was 49.5 (range, 4-148) days. The mean follow-up period was 38.1 months. The TFIS was identified as the only risk factor regarding postoperative shoulder outcome scores.

Conclusions: Acceptable outcomes can be achieved with surgical treatment for 2-part lesser tuberosity fracture with locked posterior shoulder dislocations. The TFIS has a negative impact on the final outcome.

Level of evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.