Abstract

CARVALHO, Raquel; SOUSA, Filipe; SILVA, Paulo  and  VICENTE, Miguel. Luxação posterior crónica do ombro. Rev. Port. Ortop. Traum. [online]. 2014, vol.22, n.3, pp.303-310. ISSN 1646-2122.

Unlike the anterior dislocation, the posterior dislocation is a rare entity, often with poor prognosis. Despite the few epidemiological data, these lesions occur mainly as a result of convulsions, electrocution, high-energy trauma or following electroconvulsive therapy. Despite advances in the field of diagnostic imaging, this injury is often misdiagnosed. For a correct and timely diagnosis it’s essential to have a complete physical examination and a high clinical suspicion of injury in high-risk individuals, along with appropriate radiographic investigation. Since the closed reduction, until bone and soft tissues stability procedures and arthroplasties, there are numerous surgical procedures available for the treatment of these lesions. Selecting one of them is complex and multifactorial. Given the rarity of these lesions, treatment protocols based on evidence is difficult to develop. The authors aimed to demonstrate with this clinical case, the importance of a correct diagnosis, because these lesions are usually misdiagnosed, and the good results that can be achieved with surgical treatment. Male, 34 years of age with pain and functional limitation of the right shoulder with 2 weeks of evolution after fall with local trauma. Axillary radiograph and CT scan revealed a posterior dislocation of the shoulder with a reverse Hill-Sachs injury. A reduction and filling the bony defect with the subscapularis tendon and troquino fragment was performed. At 6-month follow-up, the patient has great outcomes in DASH and Constant score.

Keywords : Posterior shoulder dislocation; glenohumeral dislocation; reverse Hill-Sachs lesion; McLaughlin; modified McLaughlin.

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