title: Balloon-guided inflation osteoplasty in the treatment of Hill-Sachs lesions of the humeral head: case report of a new technique.
abstract: BACKGROUND
  The use of the extra-vertebral balloon osteoplasty is increasing and in the meanwhile it has become a safe surgical technique in the treatment of tibial head, distal radius and calcaneus fractures. In addition, we already could show in a biomechanical setup that the balloon osteoplasty might be a safe tool for reduction in the treatment of Hill-Sachs lesions, but clinical application has not been performed so far.
  
  
  METHODS
  We report the case of a 53 year- old male patient who was referred to our Trauma department (level I trauma center) after the first manifestation of a posterior shoulder dislocation due to an epileptic seizure, originated in a- up to this date unknown -glioblastoma. After closed reduction of the dislocated shoulder the X-ray showed a subcapital fracture of the proximal humerus with a large reversed Hill-Sachs lesion. We performed an open surgery via a deltoideopectoral approach and balloon osteoplasty was used to reduce the impression fracture (Hill-Sachs lesion) before fixing the fracture with a locking plate. In the post-operative CT scan we could show an anatomical reduction of the Hill-Sachs lesion. At the follow-up examination one year after surgery the patient reached full range of motion and stated no re-dislocation of the shoulder nor instability or pain.
  
  
  CONCLUSIONS
  The reduction of an impressed humeral head fracture by use of balloon osteoplasty is a safe technique. This technique could be a new option in the treatment of Hill-Sachs lesions and might be an alternative to well known standard procedures like the remplissage or tendon transfers without affecting rotation.
authors.affiliation: Department of Traumatology, Klinikum rechts der Isar, Technical University Munich, Ismaninger Str. 22, D-81675 Munich, Germany ; Department of Traumatology, Eberhard-Karls-Universitaet, Schnarrenbergstr. 9, D-72076 Tuebingen, Germany.
authors.forename: Gunther H
authors.initials: GH
authors.lastname: Sandmann
authors.affiliation: Department of Traumatology, Klinikum rechts der Isar, Technical University Munich, Ismaninger Str. 22, D-81675 Munich, Germany ; Department of Orthopaedic Sports Medicine, Technical University Munich, Ismaninger Str. 22, D- 81675 Munich, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Siebenlist
authors.affiliation: Department of Traumatology, Klinikum rechts der Isar, Technical University Munich, Ismaninger Str. 22, D-81675 Munich, Germany ; Department of Orthopaedic Surgery, Krankenhaus Barmherzige Brueder, Romanstr. 93, D-80639 Munich, Germany.
authors.forename: Florian B
authors.initials: FB
authors.lastname: Imhoff
authors.affiliation: Department of Traumatology, Klinikum rechts der Isar, Technical University Munich, Ismaninger Str. 22, D-81675 Munich, Germany ; Department of Orthopaedic Surgery, Klinikum Mittelbaden, Lilienmattstr. 5, D-76530 Baden-Baden, Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Ahrens
authors.affiliation: Department of Traumatology, Klinikum rechts der Isar, Technical University Munich, Ismaninger Str. 22, D-81675 Munich, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Neumaier
authors.affiliation: Department of Traumatology, Eberhard-Karls-Universitaet, Schnarrenbergstr. 9, D-72076 Tuebingen, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Freude
authors.affiliation: Department of Traumatology, Klinikum rechts der Isar, Technical University Munich, Ismaninger Str. 22, D-81675 Munich, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Biberthaler
keywords: Balloon osteoplasty; Hill-Sachs lesion; Shoulder dislocation
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