Long-term follow-up of allograft reconstruction of segmental defects of the humeral head associated with posterior dislocation of the shoulder
Section snippets
Materials and methods
Between 1998 and 2002, six men underwent operative management of defects of the humeral head that involved 40% of the articular surface, following posterior dislocation of the humeral head. None of the men had a previous history of shoulder disorder. The cause of the dislocation was a grand mal seizure in three cases and a fall in three cases. For five patients, the dislocation was reduced under general anaesthesia. A computed tomography (CT) scan was performed after reduction to evaluate the
Results
We had no early or late infections, non-unions at the graft–host junction or joint instability. All the patients returned to their occupation 4 months after surgery. All the cases were evaluated clinically and by radiographs and CT scan at a mean of 122 (96–144) months after the operative procedure. Three men had no complaints of pain, instability, clicking or catching, whereas three had pain, clicking, catching and stiffness. The range of motion and the Constant score at the last follow-up
Discussion
Our study shows the long-term result of an anatomic repair with allograft as a treatment for impression fractures associated with posterior shoulder dislocation. We obtained good results in three patients and poor in other three. Of the three patients with poor results, one developed shoulder arthrosis at 8-year follow-up and the other two developed collapse of the graft and osteoarthrosis at 4-year follow-up.
The experience of several authors3, 4, 10 in chronic posterior dislocations of the
Conclusion
We think that the treatment of segmental defects of the humeral head associated with posterior dislocations of the shoulder by allograft reconstruction represents a viable technical choice, with a good long-term follow-up result in 50% of the patients.
Conflict of interest
We have no conflict of interest.
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