title: Modified MacLaughlin procedure in the treatment of neglected posterior dislocation of the shoulder.
abstract: Posterior dislocation of the shoulder is an unusual injury that most often occurs secondary to a high-energy trauma. Unfortunately the diagnosis is commonly missed, thus making its treatment a challenge. Neglected posterior dislocation is mainly characterised by an impression fracture on the anterior articular surface of the humeral head, which makes the dislocation often difficult to reduce. Diagnosis is based upon a careful history assessment, physical examination and radiological findings. Several treatment approaches have been described. The modified MacLaughlin procedure in our hands has been shown to be a reproducible technique allowing good results at medium- and long-term follow-up. According to our experience it is possible to adopt this technique also in patients with a locked posterior dislocation older than 6 months or in cases with a humeral head defect up to 50% when a shoulder prosthesis is not a good indication. Poorer results should be expected in patients with an associated fracture of the proximal humerus.
authors.affiliation: IRCCS Istituto Clinico Humanitas, Via Manzoni 56, 20089, Rozzano (MI), Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Castagna
authors.forename: Giacomo
authors.initials: G
authors.lastname: Delle Rose
authors.forename: Mario
authors.initials: M
authors.lastname: Borroni
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Markopoulos
authors.forename: Marco
authors.initials: M
authors.lastname: Conti
authors.forename: Leonardo
authors.initials: L
authors.lastname: Maradei
authors.forename: Raffaele
authors.initials: R
authors.lastname: Garofalo
mesh_terms: D000058:Accidental Falls; D000328:Adult; D001864:Bone Wires; D004830:Epilepsy, Tonic-Clonic / Q000150:complications; D005260:Female; D005593:Fracture Fixation, Internal; D006801:Humans; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012720:Severity of Illness Index; D012783:Shoulder Dislocation / Q000145:classification / Q000209:etiology / Q000601:surgery*; D012784:Shoulder Fractures / Q000150:complications / Q000601:surgery; D013536:Suture Techniques; D013997:Time Factors