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TRANSFER OF THE LESSER TUBEROSITY FOR REVERSE HILL-SACHS LESIONS AFTER NEGLECTED POSTERIOR DISLOCATIONS OF THE SHOULDER: A RETROSPECTIVE CLINICAL STUDY OF 13 CASES

MEHMET DEMİREL, ALİ ERŞEN, GÖKHAN KARADEMİR, ATA CAN ATALAR, MEHMET DEMİRHAN

Acta Orthopaedica et Traumatologica Turcica - 2017;51(5):362-366

Istanbul University, Istanbul Faculty of Medicine, Department of Orthopedics and Traumatology, Istanbul, Turkey

 

Objective: This study aimed to present middle-term functional and radiological outcomes of the transfer of the lesser tuberosity in the management of reverse Hill-Sachs lesions following posterior dislocations of the shoulder. Patients and methods: With a diagnosis of neglected posterior shoulder dislocation (8 locked, 5 recurrent), 13 male patients (age range: 28e72; mean age: 39.3 years) who underwent the transfer of the lesser tuberosity due to reverse Hill-Sachs lesions, were retrospectively reviewed based on functional and radiological data. The etiologies were: epilepsy in 9 patients, a traffic accident in 2 patients, and fall in 2 patients. To assess the patients’ functional level, American Shoulder and Elbow Surgeons (ASES) and Constant Scores were used, and the patients’ range of motion at the last follow-up was measured. To evaluate the development of arthrosis, the final follow-up control plain radiographs were examined. The average size of the defects calculated from the axial computed tomography sets was 27% (range: 20%e40%). Results: The average length of follow-up was 30 months (range: 12e67 months). At the last follow-up visit, the main ASES and Constant Scores were 78 and 85, respectively, and the average degrees of flexion, abduction, and external rotation were 163, 151, and 70 respectively. The concentric reduction was observed postoperatively. Conclusion: McLaughlin procedure appears to be a safe and effective method in the treatment of neglected posterior shoulder dislocations with reverse Hill-Sachs lesion.