A six months old neglected anterior shoulder dislocation managed by closed reduction and Latarjet procedure

Abstract

A neglected shoulder dislocation is a rarer entity and only few cases are reported in the literature. An anterior dislocation of the shoulder is rarely missed as patients present with limb in abduction and external rotation, an attitude very familiar to orthopaedic surgeon. Occasionally such cases are missed when they present with fracture of proximal humerus or when they receive treatment from unqualified practitioners who commonly practise in rural areas. Owing to very few reports there is paucity of literature and no standard treatment protocol exists for neglected anterior dislocation of the shoulder, though most such chronic cases are managed by open reduction. This case report describes a six months old neglected anterior dislocation with a significant Hill Sachs lesion, which was managed by closed reduction and Latarjet procedure.

Fig. 1

X-ray AP view of the shoulder showing dislocated anterior humeral head in a 24 years old male.

Fig. 2

Axial section of CT scan of neglected anterior shoulder dislocation showing an engaging Hill Sachs lesion.

Fig. 3

3-D CT scan image showing neglected anterior shoulder dislocation with an engaging Hill Sachs lesion.

Fig. 4

X-ray AP view of the shoulder at 3 months postoperation showing consolidated coracoid graft.