title: Long-term follow-up of allograft reconstruction of segmental defects of the humeral head associated with posterior dislocation of the shoulder.
abstract: The purpose of this study is to report the long-term follow-up result of allograft reconstruction of segmental defect of the humeral head associated with posterior dislocation of the shoulder. Six men underwent operative management of defects of the humeral head involving 40% of the articular surface, following posterior dislocation of the humeral head. The period of time between dislocation and surgery ranged from 7 to 8 weeks. The defect in the head was filled with an allogeneic segment of humeral head contoured to restore the spherical shape. All the patients returned to their occupation 4 months later. All the cases were evaluated clinically and by radiographs and computed tomography (CT) scan at a mean of 122 (96-144) months after the operative procedure. Three men had no complaints of pain, instability, clicking or catching, whereas three had pain, clicking, catching and stiffness. The three patients with good clinical result showed also good radiographic result. The computed tomography (CT) confirmed incorporation of the allograft and no osteoarthrosis. Another patient had a good clinical and radiographic result until the eighth postoperative year. At 8-year follow-up examination, this patient developed shoulder osteoarthrosis and he had pain and stiffness. He needed an arthroplasty 10 years after the operation. The other two patients developed collapse of the graft and osteoarthrosis that were yet evident at 4-year follow-up. These patients required a shoulder arthroplasty 8 years after the procedure. We conclude that the treatment of segmental defects of the humeral head associated with posterior dislocations of the shoulder by allograft reconstruction has a good long-term follow-up result in 50% of the patients.
authors.affiliation: Orthopaedic Surgery and Traumatology Service, Quiron Hospital, Zaragoza, Spain. anmarti67@yahoo.es
authors.forename: Angel Antonio
authors.initials: AA
authors.lastname: Martinez
authors.forename: Evelio
authors.initials: E
authors.lastname: Navarro
authors.forename: Daniel
authors.initials: D
authors.lastname: Iglesias
authors.forename: Javier
authors.initials: J
authors.lastname: Domingo
authors.forename: Angel
authors.initials: A
authors.lastname: Calvo
authors.forename: Ignacio
authors.initials: I
authors.lastname: Carbonel
mesh_terms: D000328:Adult; D001178:Arthroplasty / Q000009:adverse effects / Q000379:methods*; D001863:Bone Screws; D016025:Bone Transplantation / Q000009:adverse effects / Q000000981:diagnostic imaging / Q000379:methods*; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D058430:Humeral Head / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012086:Reoperation / Q000706:statistics & numerical data*; D012783:Shoulder Dislocation / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery; D020069:Shoulder Pain; D013030:Spain / Q000453:epidemiology; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014184:Transplantation, Homologous; D016896:Treatment Outcome