Recurrent posterior glenohumeral dislocation associated with increased retroversion of the glenoid. A case report.
Recurrent traumatic posterior glenohumeral dislocation is rare and probably represents < 5% of all recurrent shoulder instability cases. Operative management of this problem is considered when symptomatic recurrent instability occurs despite an adequate physician-directed rehabilitation program. Before surgery, it is essential to recognize all directions of instability and any anatomic factors that may predispose the shoulder to recurrent instability, such as humeral head or glenoid defects, abnormal glenoid version or other anthropomorphic abnormalities, rotator cuff tears, neurologic injuries, or generalized ligamentous laxity. The authors report on a patient who had 2 previous failed attempts at posterior capsulorrhaphy for recurrent posterior shoulder dislocation after an atraumatic injury. The patient demonstrated a previously unrecognized unilateral increase in glenoid fossa retroversion and was successfully treated with a posterior opening wedge osteotomy of the scapular neck.
Department of Orthopaedics, University of Texas Health Science Center at San Antonio 78284-7774.
M A
MA
Wirth
D G
DG
Seltzer
C A
CA
Rockwood
D000328:Adult; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging; D008297:Male; D010027:Osteotomy / Q000379:methods; D012008:Recurrence; D012540:Scapula / Q000601:surgery; D012783:Shoulder Dislocation / Q000000981:diagnostic imaging* / Q000534:rehabilitation / Q000601:surgery; D014057:Tomography, X-Ray Computed