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An Irreducible Posterior Fracture-Dislocation of the Shoulder: A Case Report

Posterior fracture-dislocations of the shoulder are exceedingly rare orthopedic injuries. The management of these rare and complex injuries can be challenging from initial presentation through definitive management. Timely diagnosis of these injuries is critical to prevent devastating complications,...

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Detalles Bibliográficos
Autores principales: Shermetaro, Jacob, Valk, Josiah, Sosnoski, David, Brossy, Kelley
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9142166/
https://www.ncbi.nlm.nih.gov/pubmed/35651412
http://dx.doi.org/10.7759/cureus.24535
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author Shermetaro, Jacob
Valk, Josiah
Sosnoski, David
Brossy, Kelley
author_facet Shermetaro, Jacob
Valk, Josiah
Sosnoski, David
Brossy, Kelley
author_sort Shermetaro, Jacob
collection PubMed
description Posterior fracture-dislocations of the shoulder are exceedingly rare orthopedic injuries. The management of these rare and complex injuries can be challenging from initial presentation through definitive management. Timely diagnosis of these injuries is critical to prevent devastating complications, yet the diagnosis is often delayed. Delays in surgery and poor fracture reduction are associated with a high risk of complications such as avascular necrosis. Additionally, these injuries have the potential to be irreducible. This may occur secondary to osteochondral humeral defects, soft tissue interposition, or entrapment. The long head of the biceps tendon incarceration is one potential block to reduction. Definitive surgical treatment options include open reduction and internal fixation (ORIF) and shoulder arthroplasty. While reoperation rates are higher in patients undergoing ORIF, arthroplasty longevity is a concern among young, active patients with high functional demands. Fibular strut allograft is a useful adjunct when reconstructing complex proximal humerus fractures. We present a case of a 28-year-old male who sustained a significantly comminuted four-part left proximal humerus fracture with an irreducible posterior humeral head dislocation requiring urgent ORIF following a motor vehicle accident.
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spelling pubmed-91421662022-05-31 An Irreducible Posterior Fracture-Dislocation of the Shoulder: A Case Report Shermetaro, Jacob Valk, Josiah Sosnoski, David Brossy, Kelley Cureus Orthopedics Posterior fracture-dislocations of the shoulder are exceedingly rare orthopedic injuries. The management of these rare and complex injuries can be challenging from initial presentation through definitive management. Timely diagnosis of these injuries is critical to prevent devastating complications, yet the diagnosis is often delayed. Delays in surgery and poor fracture reduction are associated with a high risk of complications such as avascular necrosis. Additionally, these injuries have the potential to be irreducible. This may occur secondary to osteochondral humeral defects, soft tissue interposition, or entrapment. The long head of the biceps tendon incarceration is one potential block to reduction. Definitive surgical treatment options include open reduction and internal fixation (ORIF) and shoulder arthroplasty. While reoperation rates are higher in patients undergoing ORIF, arthroplasty longevity is a concern among young, active patients with high functional demands. Fibular strut allograft is a useful adjunct when reconstructing complex proximal humerus fractures. We present a case of a 28-year-old male who sustained a significantly comminuted four-part left proximal humerus fracture with an irreducible posterior humeral head dislocation requiring urgent ORIF following a motor vehicle accident. Cureus 2022-04-27 /pmc/articles/PMC9142166/ /pubmed/35651412 http://dx.doi.org/10.7759/cureus.24535 Text en Copyright © 2022, Shermetaro et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Orthopedics
Shermetaro, Jacob
Valk, Josiah
Sosnoski, David
Brossy, Kelley
An Irreducible Posterior Fracture-Dislocation of the Shoulder: A Case Report
title An Irreducible Posterior Fracture-Dislocation of the Shoulder: A Case Report
title_full An Irreducible Posterior Fracture-Dislocation of the Shoulder: A Case Report
title_fullStr An Irreducible Posterior Fracture-Dislocation of the Shoulder: A Case Report
title_full_unstemmed An Irreducible Posterior Fracture-Dislocation of the Shoulder: A Case Report
title_short An Irreducible Posterior Fracture-Dislocation of the Shoulder: A Case Report
title_sort irreducible posterior fracture-dislocation of the shoulder: a case report
topic Orthopedics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9142166/
https://www.ncbi.nlm.nih.gov/pubmed/35651412
http://dx.doi.org/10.7759/cureus.24535
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