Abstract

GOMES, Diogo Silva et al. Luxação glenoumeral posterior bilateral complicada de fractura cefálica na sequência de choque eléctrico. Rev. Port. Ortop. Traum. [online]. 2014, vol.22, n.1, pp.112-119. ISSN 1646-2122.

Objective: we present a case of bilateral glenumeral posterior dislocation complicated with humeral head fracture, after electrical shock. It is particularly relevant because of the infrequency of the lesion and the option taken in its treatment. Case report: male patient, of 34 years of age, with bilateral glenoumeral posterior dislocation, in the left with a small cephalic fracture and impaction area of 30% of the articular surface, and, in the right, with cephalic fracture and impaction of 45% of the articular surface. Submitted to urgent surgical treatment: in the left, removal of the osteochondral fragment and translation of lesser tuberosity to the anterior cephalic defect (fixation with 2 screws); in the right, reduction and fixation of the osteochondral fragment and cephalic reconstruction with osteochondral graft from the contralateral humeral head, fixed with screw. To the latest follow-up, at 3 year and 8 months, the patient presented an absolute Constant Score of 92 in the left and 80 in the right, wide active range of movement (left: abduction 125º, flexion 140º, external rotation 45º and internal rotation L2; right: abduction 90º, flexion 110º, external rotation 10º and internal rotation L1) and negative instability tests bilaterally. Image study showed concentric head, bony union of the fracture and grafts, and no signs of avascular necrosis or degenerative changes. Discussion: posterior glenoumeral dislocations are rare lesions, associated with trauma by seizures or electric shocks. The area of impaction of the articular surface, associated lesions, together with age and function of the patient, should guide the treatment decision. In the presented case, the treatment option was possible due to the bilateral surgical approach in the same surgical time. This allowed to obtain a satisfactory function, with good results at 6 months post-op, that are stable even 4 years after surgery.

Keywords : Posterior glenoumeral dislocation; bilateral; electric shock; reverse Hill-Sachs lesion.

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