chronic posterior shoulder dislocation

[alfaman]

Dear Members,

Is there any shoulder expert?

I have a complicated case of chronic posterior shoulder dislocation.  A otherways healty 61 years old man had violently his arm twisted behind his back 10 weeks ago. Had a posterior shoulder dislocation. Injury was missed in rural hospital. 2 weeks ago I did open reduction, bone grafting of reverse Hill-Sachs defect and McLaughlin procedure (subscap transfer anterior to bonegraft and into the defect). Joint was temporarily transfixed with K-wire. Yesterday I removed K-wire, take X-ray and found humeral head posteriorily dislocated again.

What now?

Greetings,

Alo Kullerkann, MD
ortopeed
mob: 5158745
skype: alokullerkann
Alo Kullerkann, MD
Orthopaedic Surgeon
mob: +372 5158745
skype: alokullerkann

[amie dharia]

dear doc.

 

do you have an axillary view or a Y lateral view after surgery??

 

 

the other thing is if you did get a reduction ,you should have left the k wires for at least 6 weeks,

 

now can you please show us recent xrays ap and axillary or a y lateral

 

 

thanks

 

regards,

 

dr rajesh dharia

mumbai

 

On 9/17/09, alfaman <alf...@hot.ee> wrote:

Dear Members,
Is there any shoulder expert?
I have a complicated case of chronic posterior shoulder dislocation.

&nbsp;A otherways healty 61 years old man had violently his arm twisted
behind his back 10 weeks ago.&nbsp;Had a posterior shoulder dislocation.

[Dr Harpreet S Gill]

I believe it has to be redone and shoulder joint transfixed for atleast 6 weeks. Another option could be posterior capsular tightening with immobilization in external rotation brace.  In which position was the joint transfixed (External rotation ?) ? Can you post the latest Xrays?  Regards HS Gill SPS Apollo Hospital, Ludhiana, India --- On Thu, 9/17/09, alfaman <alf...@hot.ee> wrote:

From: alfaman <alf...@hot.ee> Subject: [Orthopod] chronic posterior shoulder dislocation To: orth...@googlegroups.com Date: Thursday, September 17, 2009, 6:10 PM

Dear Members, Is there any shoulder expert? I have a complicated case of chronic posterior shoulder dislocation.

 A otherways healty 61 years old man had violently his arm twisted behind his back 10 weeks ago. Had a posterior shoulder dislocation.

Injury was missed in rural hospital. 2 weeks ago I did open reduction, bone grafting of reverse Hill-Sachs defect and McLaughlin procedure (subscap transfer anterior to bonegraft and into the defect). Joint was temporarily transfixed with K-wire. Yesterday I removed K-wire, take X-ray and found humeral head posteriorily dislocated again. What now?

[reverberi sandro]

dear all,
if dislocation is cronicized, as this case, posterior capsule remains loose, thin  and often forms a pocket that permits a new dislocation (as anterior recurrent dislocation). Do you have tested posterior stability after your operation before closing the wound? I suggest a posterior approach, closing the pouch  and capsulorraphy ; immobilisation is in extrarotation as suggested by Dr. Harpreet.
Dr. Sandro Reverberi
Struttura semplice di Chirurgia Ortopedica Funzionale
Arcispedale S. Maria Nuova
Reggio Emilia - Italy

2009/9/17 Dr Harpreet S Gill <hgi...@yahoo.com>

[alfaman]

Dear colleques,

On the surgery, there was no posterior capsule and infraspinatus was torne. Shoulder was immobilised in slight abduction and in neutral rotation.

Latest x-rays attached. Sorry, no axial is available.

I am afraid that whatever you do it´ll end up in posterior dislocation again. Reverse shoulder arthroplasty maybe?

Alo Kullerkann

 

I believe it has to be redone and shoulder joint transfixed for atleast 6 weeks. Another option could be posterior capsular tightening with immobilization in external rotation brace. In which position was the joint transfixed (External rotation ?) ? Can you post the latest Xrays? RegardsHS GillSPS Apollo Hospital,Ludhiana, India--- On Thu, 9/17/09, alfaman <alf...@hot.ee> wrote:From: alfaman <alf...@hot.ee>Subject: [Orthopod] chronic posterior shoulder dislocationTo: orth...@googlegroups.comDate: Thursday, September 17, 2009, 6:10 PMDear Members,Is there any shoulder
expert?I have a complicated case of chronic posterior shoulder dislocation.&nbsp;A otherways healty 61 years old man had violently his arm twistedbehind his back 10 weeks ago.&nbsp;Had a posterior shoulder dislocation.Injury was missed in rural hospital. 2 weeks ago I did open reduction,bone grafting of reverse Hill-Sachs defect and McLaughlin procedure(subscap transfer anterior to bonegraft and into the defect). Joint wastemporarily transfixed with K-wire. Yesterday I removed K-wire, takeX-ray and found humeral head posteriorily dislocated again.What now?Greetings,Alo Kullerkann, MDortopeedmob:5158745skype: alokullerkannAlo Kullerkann, MDOrthopaedicSurgeonmob: +372 5158745skype:

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