title: Proximal humerus derotational osteotomy for internal rotation instability after locked posterior shoulder dislocation: early experience in four patients.
abstract: BACKGROUND
  We performed a retrospective and descriptive study to determine the feasibility of proximal humerus derotational osteotomy in younger patients with significant humeral head depression, who may not be good candidates for shoulder arthroplasty.
  
  
  METHODS
  Rotational osteotomy was done on four patients with a mean age of 40 for locked posterior dislocation associated with a reverse Hill-Sachs lesion from 2000-2011. The average age was 40 +/- 11 years old and the average follow up was 22 +/- 8 months. Shoulder stability, range of motion, radiographic outcome and postoperative complications were assessed. Average follow-up was 22 months (range, 12-30 months) postoperatively.
  
  
  RESULTS
  The average range of motion of the shoulders at the final follow-up were as follows (Mean +/- Standard deviation): Abduction: 125 +/- 29°, Forward flexion: 135 +/- 17°, Internal rotation: 65 +/- 17°, External rotation: 62 +/- 10°. There were no wound or neurological complications and no dislocations. Patients were satisfied with their functional status and did not have any further symptoms of instability or rotator cuff dysfunction.
  
  
  CONCLUSIONS
  Proximal humerus derotational osteotomy for acute locked posterior dislocation of the shoulder can be a viable option for younger age group, which can facilitate rehabilitation for these patients by providing immediate stability.
authors.affiliation: Gwinnett Medical Center, 575 Professional Dr., Suite 360, Lawrenceville, GA 30046 USA.
authors.forename: Bruce
authors.initials: B
authors.lastname: Ziran
authors.affiliation: Atlanta Medical Center, 303 Parkway Dr. NE, Atlanta, GA 30312 USA.
authors.forename: Ali
authors.initials: A
authors.lastname: Nourbakhsh
keywords: Derotational osteotomy; Hill-Sachs lesion; Humerus