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PubMedDate not supplied

Partial prosthetic replacement of the shoulder in fractures and fracture-dislocations of the proximal humerus.

A total of 48 patients submitted to partial shoulder replacement for fracture and fracture-dislocation of the proximal humerus were evaluated after a mean follow-up of 5.2 years (range 2 to 10 years). The absolute mean Constant score was 57.8, relative score 76.8% and corrected score 80.4%. A mean of 8.8 points were totalled in the Simple Shoulder Test. Out of 45 patients evaluated radiographically, tuberosity consolidation in the anatomical site was evident in 25 shoulders (55%) and the subacromial space appeared to be preserved in 20 shoulders (44%). More than 90% of the patients declared that he or she was satisfied with treatment. A comparative study on subgroups of patients in an attempt to identify the prognostic value of several factors was conducted. Better functional results were obtained in subjects aged under 70 years, in fracture-dislocations, in shoulders with whole rotator cuffs, in patients with dedicated modular prostheses.

Aged↗
PubMed1996

Traumatic posterior dislocation of the shoulder with fracture of the acromion in a child.

Posterior dislocation of the shoulder is extremely rare in children. We encountered a posterior dislocation of the shoulder complicated by fracture of the acromion in a 14-year-old boy. He recovered uneventfully after immediate manual reduction performed under general anesthesia and truncal plaster cast fixation. Early diagnosis and treatment are considered to be especially important in managing this injury.

Acromion↗
PubMed1992

[Extended surgical indications in combined shoulder girdle fracture].

The combination of an ipsilateral clavicule and scapula fracture causes a double instability of the shoulder. In opposite to an isolated clavicule or scapula fracture this injury should be treated operatively. Diagnosis of the scapula fracture in polytrauma can be difficult. If there is a clinical or radiologic suspicion, the indication for a CT scan is given. Osteosynthesis with plates from separated approaches, first the scapula from dorsal then the calvicule from ventral has proven good. The nervus suprascapularis must be treated carefully and, if necessary, liberated from the fracture. The optimal treatment of this injury is not always possible in polytraumatised patient.

Clavicle↗
PubMed1994

[Anatomic reconstruction of posterior shoulder dislocation fractures. A new method using bone anchors].

The posterior shoulder dislocation is often misdiagnosed. The overall cost in medical care is about six times higher than an anterior dislocation. For the precise diagnosis, correct x-rays in exact ap- and Y-view of the shoulder are essential. The ultimate analysis can be made by a CT-scan. An alternative method is presented to reconstruct the defects (reversed Hill-Sachs) by particular placing of anchors (Mitek). One to two years after, no recurrence of dislocations could be observed (9 cases). In two cases an arthroscopic mobilisation of the shoulder had to be done to regain full range of motion after 4 months.

Arthroscopy↗
PubMed2000

Fractures about the shoulder: conservative management.

Fractures about the shoulder are a frequent occurrence. The clavicle and the proximal humerus are fractured much more often than the scapula. Appropriate diagnosis of these injuries and any associated injuries is essential. The vast majority of these fractures may be treated conservatively with good functional results.

Clavicle↗
PubMed1997

[A case of posterior dislocation of the shoulder with fracture of the humeral neck].

A case of posterior dislocation of the shoulder with concomitant fracture of the humeral neck and diagnostic difficulties are discussed. An axial radiograph of the shoulder was omitted at the first examination and posterior dislocation was unrecognized. It was diagnosed only after one month. Surgical reduction with Steinman pin and Kirschner wires fixation rendered good final outcome.

Fracture Fixation↗
PubMed1998

Simultaneous anterior dislocation of the shoulder and fracture of the ipsilateral humeral shaft. Two case reports.

Two patients with anterior dislocation of the shoulder and ipsilateral fracture of the shaft of the humerus have been studied and the mechanism of their injuries has been documented. Closed reduction of the dislocations was performed under anaesthesia during surgery for humeral fixation with a dynamic compression plate. The fractures and dislocations healed without any problems at 6 to 9 months postoperatively. At recent follow-up, one patient had returned to work and regained normal mobility. The other patient had the sequelae of a brachial plexus injury. The literature on this subject is reviewed.

Adult↗
PubMed1985

[Bilateral shoulder dislocation fractures, femoral neck and vertebral fractures: a remarkable combination of injuries during an epileptic seizure].

Fracture complications of convulsions are reported occasionally, e.g.: mono- or bilateral posterior shoulder luxations and luxation fractures, central dislocations of the hip as well as fractures of the femoral neck or compression fractures of vertebrae. A case is reported where the patient sustained four such lesions simultaneously. The epileptic seizure occurred following the sudden interruption of a neurotropic therapy with Carbamazepin (Tegretal). A general osteodystrophy was not found. The simultaneous presence of four such lesions following one convulsion has never before been reported and appears to be very uncommon. The frequency and problems of post-epileptic fractures are discussed and the operative treatment of the lesions briefly described.

Adult↗
PubMed1996

[Posterior dislocation fracture of the shoulder].

Posterior dislocation fracture of the shoulder is a rare injury that often occurs in association with a grand mal seizure. Our aim with this paper is to emphasize diagnosis and therapy. In the past 5 years seven patients with nine posterior dislocation fractures were treated operatively. In six patients a grand mal seizure was the cause of the injury and in one a direct trauma. Three four-part fractures were found in two patients and six locked posterior dislocation fractures in five patients. Clinical examination in locked posterior dislocation fractures showed a lack of external rotation, and flexion was performed by movement of the scapula. Radiological examination demonstrated an overlapping of the contours of the humeral head and the glenoid and the "trough line". The operations were performed in the time between 4 h and 10 days later. Two of three four-part fractures (in one patient) were treated with hemiarthroplasties, and one was fixed with screws. Closed reduction was attempted in six shoulders but was possible only in one patient. In this patient a redislocation occurred 3 days later and a combined anterior and posterior approach was done. A fracture of the anatomical neck was produced in another shoulder. Six open reductions and stabilizations with screws were performed, and three times we fixed the subscapular tendon in the reversed Hill-Sachs lesion with anchor sutures. Patients after grand mal seizures may have a posterior shoulder dislocation, and clinical and radiological examination should be emphasized. In locked posterior dislocation we favour early open reduction, fixation of the subscapular tendon with anchor sutures in the reversed Hill-Sachs lesion and stabilization of the lesser tuberosity with screws.

Adult↗