Luxación posterior inveterada de hombro asociada a lesión de Hill-Sachs reversa tratada con modificación de la técnica de McLaughlin / Unreduced posterior dislocation of the shoulder with an associated reverse Hill-Sachs injury treated with a modified McLaughlin technique

Resumen: Introducción: Las luxaciones posteriores de hombro son raras (2%) y se asocian a convulsiones, electrocuciones y traumatismos de alta energía. Pueden presentarse asociadas a una lesión de Hill Sachs reversa. Uno de los principios del tratamiento consiste en la transferencia del tendón subescapular hacia el área de lesión o procedimiento de McLaughlin. Caso clínico: Se expone el caso de un masculino con un defecto de Hill-Sachs reverso tratado con una modificación de la técnica original de McLaughlin. Se reportan los resultados funcionales tras 13 meses de la cirugía. Resultados: Actualmente con un Constant Score de 98 puntos. Discusión: La modificación técnica empleada para el tratamiento quirúrgico de la lesión de Hill Sachs reversa presentada en este paciente demostró bueos resultados funcionales con material de bajo costo.

Abstract: Introduction: Posterior shoulder dislocations are rare (2%) and are associated with seizures, electrocutions and high-energy trauma. They may be associated with a reverse Hill-Sachs lesion. One of the treatment principles consists of the subscapular tendon transfer to the injury area or McLaughlin procedure. Clinical case: A case of a man with a reverse Hill-Sachs defect treated with a modification of McLaughlin's original technique is presented. The functional results after 13 months of surgery are reported. Results: Currently with a Constant Score of 98 points. Conclusion: The technical modification used for the surgical treatment of the reverse Hill-Sachs lesion presented in this patient demonstrated good functional results with low cost material.

Clinical effects of shoulder dislocation combined with reverse Hill-sachs injury treated with Neer modified McLaughlin procedure / 天津医药

Objective To evaluate clinical efficacy of shoulder dislocation combined with reverse Hill-sachs injury treated with Neer modified McLaughlin procedure. Methods Clinical data of seven patients for shoulder dislocation combined with reverse Hill-sachs injury in our hospital from October 2013 to June 2016 were retrospectively analyzed. All of the patients were received Neer modified McLaughlin procedure with defect area of humeral head from 25%to 40%. The clinical outcomes were evaluated with plain radiographs, subjective satisfaction, range of shoulder motion, University of Califonia Los Angeles (UCLA) shoulder scale and constant score, which were recorded at the final follow up. Results The mean follow-up period was (12.3 ± 4.3) months. No recurence of shoulder dislocation was found. At the final follow up, a patient was found a slight osteoarthritis based on radiographs. Two patients were very satisfied with the surgery and five patients were satisfied. The average anterior flexion, abduction and external rotation of shoulder were 145.7° ± 12.7° and 148.6° ± 15.7° and 47.1° ± 5.7° respectively. The average UCLA score and constant score were (26.6 ± 2.8) and (78.6 ± 7.2) respectively. Conclusion The Neer modified McLaughlin procedure shows a remarkable clinical effect for shoulder dislocation combined with reverse Hill-sachs injury. The short and mid-term effects are definite with few complications.