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. 2022 Sep;106(3):239-245.
doi: 10.1007/s12306-021-00702-1. Epub 2021 Mar 8.

Locked anterior glenohumeral dislocation: is it always recommendable a conservative treatment?

Michele Novi  1 , Luigi Tarallo  2 , Alessandra Colozza  3 , Paolo Paladini  4 , Gianmario Micheloni  5 , Fabio Catani  2 , Giuseppe Porcellini  2
Affiliations

Locked anterior glenohumeral dislocation: is it always recommendable a conservative treatment?

Michele Novi et al. Musculoskelet Surg. 2022 Sep.

Abstract

Purpose: Chronic anterior shoulder dislocation represents a rare condition, and there is still lack of consensus in its treatment. Purpose of this study is to evaluate the clinical and radiological outcome of painful locked dislocation underwent shoulder replacement, with a minimum follow-up of two years. Second endpoint is to assess the glenoid bone graft, harvested from the humeral head.

Methods: Eight patients underwent shoulder replacement for locked anterior shoulder dislocation. Four patients with a mean age of 23 y.o. were treated with Pyrocarbon-hemiarthroplasty and four patients with a mean age of 76 y.o. were treated with reverse shoulder arthroplasty. Glenoid single stage reconstruction was performed with a bone autograft harvested from the resected humeral head. Patients were observed for a clinical and radiological follow-up for a minimum period of 2 years; ASES and Constant score were assessed.

Results: Pain and ROM improvement was reported in all the patients. In one case, postoperative recurrent RSA instability was found. Glenoid reconstruction was performed in seven cases, showing a good integration and no reabsorption issues in all but one cases. ASES and Constant-Murley functional outcomes were rated as excellent by 1 patient with pyrocarbon HA and 1 patient with RSA, good by 3 patients with RSA and 2 patients with HA, fair by 1 patient with HA and poor by one patient with RSA.

Conclusion: The treatment of locked anterior glenohumeral dislocation still represents a challenge in symptomatic patients. Shoulder replacement showed good results in young and older patients, with HA and RSA, respectively. Autograft from the humeral head is reliable for glenoid defect, even in ream and run procedure. Locked dislocation lasting more than one year, surgery is debatable for higher risk of a poor outcome and recurrent instability.

Keywords: Bone graft; Chronic anterior shoulder dislocation; Glenoid reconstruction; Hemiarthroplasty; Locked anterior shoulder dislocation; Reverse shoulder Arthroplasty; Shoulder replacement.

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References

    1. Cutts S, Prempeh M, Drew S (2009) Anterior shoulder dislocation. Ann R Coll Surg Engl 91(1):2–7. https://doi.org/10.1308/003588409X359123 - DOI - PubMed - PMC
    1. Hovelius L. (1987) Anterior Five-year prognosis. J Bone Joint Surg Am., 69(3): 393–399.
    1. Rowe CR, Zarins B (1982) Chronic unreduced dislocations of the shoulder. J Bone Joint Surg Am 64(4):494–505 - DOI
    1. Flatow EL, Miller SR, Neer CS (1993) Chronic anterior dislocation of the shoulder. J Shoulder Elb Surg 2(1):2–10. https://doi.org/10.1016/S1058-2746(09)80131-6 - DOI
    1. Chaudhary D, Joshi D, Jain V, Mohindra M, Mehta N (2016) A six months old neglected anterior shoulder dislocation managed by closed reduction and Latarjet procedure. Chinese J Traumatol - English Ed 19(5):295–297. https://doi.org/10.1016/j.cjtee.2016.06.005 - DOI

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