Chronic non-treated posterior fracture-dislocation of the shoulder

About authors

Pirogov Russian National Research Medical University, Moscow, Russia

Correspondence should be addressed: Denis A. Badriev
Ostrovityanova, 1, Moscow, 117997, Russia; ur.liam@nad1lli

About paper

Author contribution: all authors made equal contributions to the study and preparation of the article.

Compliance with ethical standards: the study was approved by Ethical Review Board at the Pirogov Russian National Research Medical University (Protocol No. 202 of November 23, 2020) and carried out in compliance with ethical standards established by the Declaration of Helsinki; the patient provided written informed consent for data processing and publication.

Received: 2022-04-09 Accepted: 2022-04-15 Published online: 2022-04-29

Posterior fracture-dislocations often remain undiagnosed at initial medical attendance. In dislocation, the head of the humerus extends beyond the glenoid to form a zone of impaction, which “fixes” it. The injury is almost unidentifiable in standard frontal X-ray images. Meanwhile, continued fixation of the humerus in the state of posterior dislocation leads to a rapid progression of the traumatic impaction over up to 50% of the articular surface area. The associated damage to the articular lip of the scapula, rupture of the rotator cuff muscles, symptoms of shoulder instability after relocation, and severe pain syndrome require advanced treatments for this type of injury. Here we report a clinical case of anatomical neck fracture of the humerus with displaced consolidation, combined to posterior dislocation. To avoid subacromial impingement, instead of correcting the position of the head, we abandoned the reposition and performed an osteotomy with distal displacement of the greater tubercle of the humerus.

Keywords: posterior dislocation of the shoulder, fracture-dislocation of the shoulder, shoulder joint surgery