title: Open reduction and posterior capsular shift for cases of neglected unreduced posterior shoulder dislocation.
abstract: 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.
authors.affiliation: Orthopedic Department, Cairo University, Cairo, Egypt. mshewy@gmail.com
authors.forename: Mohamed Taha
authors.initials: MT
authors.lastname: El Shewy
authors.forename: Hassan Magdy
authors.initials: HM
authors.lastname: El Barbary
authors.forename: Yasser Hassan
authors.initials: YH
authors.lastname: El Meligy
authors.forename: Sherif Ahmed
authors.initials: SA
authors.lastname: Khaled
mesh_terms: 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