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Shoulder-Preserving Surgery in Case of Defect of more than half of the Joint Surface: A Case Report

INTRODUCTION: This report highlights chronic locked posterior shoulder dislocation, which is of special interest because the patient who had a reverse Hill-Sachs and Hill-Sachs lesion, with >50% joint surface defects was treated with a shoulder-preserving surgery. CASE REPORT: A 42-year-old man p...

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Autor principal: Gurger, Murat
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Indian Orthopaedic Research Group 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6727453/
https://www.ncbi.nlm.nih.gov/pubmed/31534941
http://dx.doi.org/10.13107/jocr.2250-0685.1380
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author Gurger, Murat
author_facet Gurger, Murat
author_sort Gurger, Murat
collection PubMed
description INTRODUCTION: This report highlights chronic locked posterior shoulder dislocation, which is of special interest because the patient who had a reverse Hill-Sachs and Hill-Sachs lesion, with >50% joint surface defects was treated with a shoulder-preserving surgery. CASE REPORT: A 42-year-old man presented to our clinic with complaints of pain and limited movement in his left shoulder. The patient’s complaints began after he experienced a fall 7 months ago. The patient was believed to have experienced posterior shoulder dislocation, and the clinical diagnosis was confirmed by radiological imaging. Computed tomography revealed a reverse Hill-Sachs lesion on the humeral head and on approximately 25% of the joint surface. During the McLaughlin procedure, because the osteoporotic humerus showed a collapse of approximately 30% on the posterior articular surface, an iatrogenic Hill-Sachs lesion was added to the reverse Hill-Sachs lesion at the beginning of the humeral head. The subscapularis tendon was transferred to the anterior defective area of the humeral head with three anchor sutures. Fixation was performed with a Kirschner wire, while the joint was in the reduction position. At the 62-month follow-up, constant shoulder score was calculated as 84. The patient was pleased with his results and was able to continue his routine activities. CONCLUSION: Arthroplasty is the recommended treatment for patients manifesting >50% defect on the humeral head joint surface. However, when these defects are evaluated, factors such as their localization, size, depth, and orientations with respect to the glenoid should be considered. Only after this multifaceted evaluation, appropriate surgical interventions can be planned.
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spelling pubmed-67274532019-09-18 Shoulder-Preserving Surgery in Case of Defect of more than half of the Joint Surface: A Case Report Gurger, Murat J Orthop Case Rep Case Report INTRODUCTION: This report highlights chronic locked posterior shoulder dislocation, which is of special interest because the patient who had a reverse Hill-Sachs and Hill-Sachs lesion, with >50% joint surface defects was treated with a shoulder-preserving surgery. CASE REPORT: A 42-year-old man presented to our clinic with complaints of pain and limited movement in his left shoulder. The patient’s complaints began after he experienced a fall 7 months ago. The patient was believed to have experienced posterior shoulder dislocation, and the clinical diagnosis was confirmed by radiological imaging. Computed tomography revealed a reverse Hill-Sachs lesion on the humeral head and on approximately 25% of the joint surface. During the McLaughlin procedure, because the osteoporotic humerus showed a collapse of approximately 30% on the posterior articular surface, an iatrogenic Hill-Sachs lesion was added to the reverse Hill-Sachs lesion at the beginning of the humeral head. The subscapularis tendon was transferred to the anterior defective area of the humeral head with three anchor sutures. Fixation was performed with a Kirschner wire, while the joint was in the reduction position. At the 62-month follow-up, constant shoulder score was calculated as 84. The patient was pleased with his results and was able to continue his routine activities. CONCLUSION: Arthroplasty is the recommended treatment for patients manifesting >50% defect on the humeral head joint surface. However, when these defects are evaluated, factors such as their localization, size, depth, and orientations with respect to the glenoid should be considered. Only after this multifaceted evaluation, appropriate surgical interventions can be planned. Indian Orthopaedic Research Group 2019 /pmc/articles/PMC6727453/ /pubmed/31534941 http://dx.doi.org/10.13107/jocr.2250-0685.1380 Text en Copyright: © Indian Orthopaedic Research Group http://creativecommons.org/licenses/by-nc/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Gurger, Murat
Shoulder-Preserving Surgery in Case of Defect of more than half of the Joint Surface: A Case Report
title Shoulder-Preserving Surgery in Case of Defect of more than half of the Joint Surface: A Case Report
title_full Shoulder-Preserving Surgery in Case of Defect of more than half of the Joint Surface: A Case Report
title_fullStr Shoulder-Preserving Surgery in Case of Defect of more than half of the Joint Surface: A Case Report
title_full_unstemmed Shoulder-Preserving Surgery in Case of Defect of more than half of the Joint Surface: A Case Report
title_short Shoulder-Preserving Surgery in Case of Defect of more than half of the Joint Surface: A Case Report
title_sort shoulder-preserving surgery in case of defect of more than half of the joint surface: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6727453/
https://www.ncbi.nlm.nih.gov/pubmed/31534941
http://dx.doi.org/10.13107/jocr.2250-0685.1380
work_keys_str_mv AT gurgermurat shoulderpreservingsurgeryincaseofdefectofmorethanhalfofthejointsurfaceacasereport