title: The success of closed reduction in acute locked posterior fracture-dislocations of the shoulder.
abstract: We retrospectively reviewed the results of closed treatment in 7 patients with acute locked posterior fracture-dislocations of the shoulder. Shoulders were reduced with patients under general anesthesia and were splinted in neutral rotation for 6 weeks. Follow-up averaged 46 months (range, 24-88 months). All shoulders were reduced within 14 days. Humeral head defects ranged from 18% to 32% of the articular surface, and all patients had documented posterior instability under anesthesia after relocation. Of the 7 patients, 6 had a stable shoulder. The mean American Shoulder and Elbow Surgeons shoulder index was 93.5 (range, 83-100). The mean findings with regard to motion were active forward elevation to 169 degrees , external rotation to 73 degrees , and internal rotation to T11. All patients without preexisting shoulder pathology were treated successfully. Closed management of acute posterior fracture-dislocations can be highly successful, even in the face of instability under anesthesia and a 30% humeral head defect.
authors.affiliation: Peachtree Orthopaedic Clinic, Atlanta, GA 30309, USA.
authors.forename: Xavier A
authors.initials: XA
authors.lastname: Duralde
authors.forename: Evander F
authors.initials: EF
authors.lastname: Fogle
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000768:Anesthesia, General; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000209:etiology; D008297:Male; D008349:Manipulation, Orthopedic / Q000379:methods*; D008875:Middle Aged; D012189:Retrospective Studies; D012783:Shoulder Dislocation / Q000150:complications / Q000601:surgery*; D012784:Shoulder Fractures / Q000150:complications / Q000601:surgery*; D013165:Splints