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Open anterior glenohumeral dislocation with associated supraspinatus avulsion: A case report

BACKGROUND: Open dislocation of the glenohumeral joint is a very rare complication with only six cases described in the literature. Most cases resulted in severe complications like avascular necrosis of the humeral head or septic arthritis with poor functional results. The “mandatory” treatment of c...

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Autores principales: Faur, Cosmin Ioan, Anglitoiu, Bogdan, Ungureanu, Ana-Maria
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6473123/
https://www.ncbi.nlm.nih.gov/pubmed/31024956
http://dx.doi.org/10.12998/wjcc.v7.i7.849
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author Faur, Cosmin Ioan
Anglitoiu, Bogdan
Ungureanu, Ana-Maria
author_facet Faur, Cosmin Ioan
Anglitoiu, Bogdan
Ungureanu, Ana-Maria
author_sort Faur, Cosmin Ioan
collection PubMed
description BACKGROUND: Open dislocation of the glenohumeral joint is a very rare complication with only six cases described in the literature. Most cases resulted in severe complications like avascular necrosis of the humeral head or septic arthritis with poor functional results. The “mandatory” treatment of choice is surgery, with accurate debridement and reconstruction of the damaged soft tissues. However, the results in these cases do not approach those seen in classical dislocations. CASE SUMMARY: This case report is the first description of an anterior open glenohumeral dislocation without associated fractures, but with complete avulsion of the soft tissue envelope of the proximal humerus. Surgical treatment consisted of copious lavage with saline solution, meticulous debridement of the nonviable soft tissues, reduction of the dislocated humeral head and reconstruction of the soft tissue envelope of the humeral head. The selected surgical approach was an inferior extension of the wound at the level of the delto-pectoral groove, as the best choice to be able to perform an adequate debridement and capsulo-tendinous reinsertion. At 6 mo there were no clinical signs of instability of the glenohumeral joint, the functionality of the joint was restricted to 90º of anterior elevation, internal rotation to L2, with severe limitation of abduction (60º) and external rotation (0º) but without residual pain, with an Oxford shoulder Score of 28. CONCLUSION: Thorough reconstruction of the soft tissues surrounding the shoulder joint and an early rehabilitation program are key points to a good functional result.
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spelling pubmed-64731232019-04-25 Open anterior glenohumeral dislocation with associated supraspinatus avulsion: A case report Faur, Cosmin Ioan Anglitoiu, Bogdan Ungureanu, Ana-Maria World J Clin Cases Case Report BACKGROUND: Open dislocation of the glenohumeral joint is a very rare complication with only six cases described in the literature. Most cases resulted in severe complications like avascular necrosis of the humeral head or septic arthritis with poor functional results. The “mandatory” treatment of choice is surgery, with accurate debridement and reconstruction of the damaged soft tissues. However, the results in these cases do not approach those seen in classical dislocations. CASE SUMMARY: This case report is the first description of an anterior open glenohumeral dislocation without associated fractures, but with complete avulsion of the soft tissue envelope of the proximal humerus. Surgical treatment consisted of copious lavage with saline solution, meticulous debridement of the nonviable soft tissues, reduction of the dislocated humeral head and reconstruction of the soft tissue envelope of the humeral head. The selected surgical approach was an inferior extension of the wound at the level of the delto-pectoral groove, as the best choice to be able to perform an adequate debridement and capsulo-tendinous reinsertion. At 6 mo there were no clinical signs of instability of the glenohumeral joint, the functionality of the joint was restricted to 90º of anterior elevation, internal rotation to L2, with severe limitation of abduction (60º) and external rotation (0º) but without residual pain, with an Oxford shoulder Score of 28. CONCLUSION: Thorough reconstruction of the soft tissues surrounding the shoulder joint and an early rehabilitation program are key points to a good functional result. Baishideng Publishing Group Inc 2019-04-06 2019-04-06 /pmc/articles/PMC6473123/ /pubmed/31024956 http://dx.doi.org/10.12998/wjcc.v7.i7.849 Text en ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
spellingShingle Case Report
Faur, Cosmin Ioan
Anglitoiu, Bogdan
Ungureanu, Ana-Maria
Open anterior glenohumeral dislocation with associated supraspinatus avulsion: A case report
title Open anterior glenohumeral dislocation with associated supraspinatus avulsion: A case report
title_full Open anterior glenohumeral dislocation with associated supraspinatus avulsion: A case report
title_fullStr Open anterior glenohumeral dislocation with associated supraspinatus avulsion: A case report
title_full_unstemmed Open anterior glenohumeral dislocation with associated supraspinatus avulsion: A case report
title_short Open anterior glenohumeral dislocation with associated supraspinatus avulsion: A case report
title_sort open anterior glenohumeral dislocation with associated supraspinatus avulsion: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6473123/
https://www.ncbi.nlm.nih.gov/pubmed/31024956
http://dx.doi.org/10.12998/wjcc.v7.i7.849
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