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Case Reports
. 2017 Nov-Dec;7(6):24-26.
doi: 10.13107/jocr.2250-0685.934.

Open Reduction and Internal Fixation of Posterior Fracture Dislocation of the Shoulder Made Easy!

Waqar Saadat  1 , Puneet Monga  2
Affiliations
Case Reports

Open Reduction and Internal Fixation of Posterior Fracture Dislocation of the Shoulder Made Easy!

Waqar Saadat et al. J Orthop Case Rep. 2017 Nov-Dec.

Abstract

Introduction: Posteriorly dislocated humeral head fracture has a great implication, as it is associated with high risk of avascular necrosis, limited access through the deltopectoral approach, and posterior approach to the posteriorly dislocated humeral fracture increases the risk to the remaining blood supply.

Technical tip: Posteriorly dislocated humeral fracture is approached through deltopectoral approach. Schanz pin is inserted into the humeral head to achieve purchase in the humeral head. Applying laterally directed force the humeral head is disengaged from the lateral margin of glenoid. A rotatory force then repositions the humeral head into a congruous position. Open reduction internal fixation is then carried out in a standard fashion.

Conclusion: Retrieving the humeral head from the posteriorly dislocated position in patients with posterior fracture dislocation of the shoulder can be challenge to a trauma surgeon. With this novel technique, humeral head is reduced through deltopectoral approach without increasing the risk to the remaining blood supply.

Keywords: Posterior shoulder dislocation; Schanz screw; avascular necrosis; deltopectoral approach.

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Figures

Figure 1
Figure 1
Computed tomography scan of the posteriorly dislocated proximal humerus fracture with fragment engaged on glenoid
Figure 2
Figure 2
3D computed tomography reconstruction.
Figure 3
Figure 3
Diagram showing engaged posteriorly dislocated humeral fracture.
Figure 4
Figure 4
Diagram showing disengaged posteriorly dislocated humeral fracture.
See this image and copyright information in PMC

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