Open reduction and posterior capsular shift for cases of neglected unreduced posterior shoulder dislocation.
BACKGROUND
Neglected unreduced posterior shoulder dislocation is a challenging orthopaedic problem.


OBJECTIVE
To evaluate the results of open reduction with posterior cruciate capsular repair for such cases. This corrects the wide posterior capsule, which is the main pathologic entity.


METHODS
Case series; Level of evidence, 4.


METHODS
Over a period of 5 years, 17 patients with unreduced neglected posterior shoulder dislocation with an impression fracture involving less than 25% of the humeral head were treated by open reduction together with posterior cruciate capsular repair as described by Neer. The patients' average age was 48.5 years (range, 32.5-66 years). There were 14 men and 3 women. The dominant shoulder was affected in 14 cases.


RESULTS
After a minimum follow-up of 5 years (range, 5-10 years), the average UCLA score improved from 18 preoperatively to 33 postoperatively. The average modified Rowe score changed from 42.2 to 78.4 points. The American Shoulder and Elbow Surgeons Shoulder score showed an average of 40.3 points preoperatively and an average of 79.8 points at final follow-up. Three patients developed late osteoarthritic changes. Two had changes of mild degree, and 1 needed a total shoulder replacement.


CONCLUSIONS
Open reduction with posterior cruciate capsular repair offers a good solution for the problem of neglected unreduced posterior shoulder dislocation excluding cases with osteoarthritic changes and those with impression fracture involving less than 25% of the head.
El Shewy
Mohamed Taha
MT
Orthopedic Department, Cairo University, Cairo, Egypt. mshewy@gmail.com
El Barbary
Hassan Magdy
HM
El Meligy
Yasser Hassan
YH
Khaled
Sherif Ahmed
SA
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012783:Shoulder Dislocation / Q000503:physiopathology / Q000601:surgery*; D012785:Shoulder Joint / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors