Arthroscopic treatment of reverse Hill-Sachs injury avoiding internal fixation: Case report

Authors

  • Juan Carlos Jaramillo Fernández Clínica del Campestre. Medellín, Colombia
  • Andrés Arismendi Montoya Clínica del Campestre. Medellín, Colombia
  • María del Pilar Duque Orozco DuPont Hospital for Children. Wilmington, Estados Unidos

DOI:

https://doi.org/10.1016/j.rccot.2015.09.002

Keywords:

posterior shoulder dislocation, proximal humeral fracture, percutaneous disimpaction, arthroscopy, evidence level: IV

Abstract

Traumatic posterior shoulder joint dislocation associated with a Hill-Sachs fracture is still considered a rare condition, but yet, surgical treatment is a challenge for shoulder surgeons. The majority of currently described surgical techniques aim to modify proximal humeral anatomy and are complex procedures. Herein we describe a minimal invasive surgical technique, consisting of an arthroscopic-guided percutaneous fracture disimpaction without the use of any fixation device for permanent reduction. A case report is presented of a patient with a reverse Hill-Sachs lesion after a traumatic posterior dislocation, treated arthroscopically without the use of any type of osteosynthesis materials.

Downloads

Download data is not yet available.

Author Biographies

Juan Carlos Jaramillo Fernández, Clínica del Campestre. Medellín, Colombia

Médico Ortopedista, Clínica de hombro y codo, Hospital Pablo Tobón Uribe, Clínica del Campestre, Medellín, Colombia.

Andrés Arismendi Montoya, Clínica del Campestre. Medellín, Colombia

Médico Ortopedista, Clínica de hombro y codo, Hospital Pablo Tobón Uribe, Clínica del Campestre, Medellín, Colombia.

María del Pilar Duque Orozco, DuPont Hospital for Children. Wilmington, Estados Unidos

Ortopedista y traumatóloga, Research Fellow Alfred I. DuPont Hospital for Children, Wilmington, Estados Unidos.

References

Hawkins RJ, Neer CS, Pianta RM, Mendoza FX. Locked posterior dislocation of the shoulder. J Bone Joint Surg Am. 1987;69:9- 18. https://doi.org/10.2106/00004623-198769010-00003

McLaughlin HL. Posterior dislocation of the shoulder. J Bone Joint Surg Am. 1952;24-A-3:584-90. https://doi.org/10.2106/00004623-195234030-00011

Moroder P, Resch H, Tauber M. Failed arthroscopic repair of a large reverse Hill-Sachs lesion using bone allograft and cannulated screws: a case report. Arthroscopy. 2012;28:138- 44. https://doi.org/10.1016/j.arthro.2011.09.020

Hill HA, Sachs MD. The grooved defect of the humeral head. A frequently unrecognized complication of dislocations of the shoulder joint. Radiology. 1940;35:690-700. https://doi.org/10.1148/35.6.690

Burkhart SS, De Beer JF. Traumatic glenohumeral bone defects and their relationship to failure of arthroscopic Bankart repairs. Arthroscopy. 2000;16:677-694. https://doi.org/10.1053/jars.2000.17715

Magnusson L, Kartus J, Ejerhed L, Hultenheim I, Sernert N, Karlsson J. Revisiting the open bankart experience: a fourto nine-year follow-up. Am J Sports Med. 2002;30:778-82. https://doi.org/10.1177/03635465020300060401

Engel T, Hepp P, Osterhov G, Josten C. Arthroscopic reduction and subchondral support of reverse Hill-Sachs lesions with a bioabsorbable interference screw. Arch Orthop Trauma Surg. 2009;129:1103-7. https://doi.org/10.1007/s00402-009-0840-x

Cicak N. Posterior dislocation of the shoulder. J Bone Joint Surg Br. 2004;86:324-32. https://doi.org/10.1302/0301-620X.86B3.14985

Assom M, Castoldi F, Rossi R, Blonna D, Rossi P. Humeral head impression fracture in acute posterior shoulder dislocation: new surgical technique. Knee Surg Sports Traumatol Arthrosc. 2006;14:668-72. https://doi.org/10.1007/s00167-005-0001-x

Stein DA, Jazrawi L, Bartolozzi AR. Arthroscopic stabilization of anterior shoulder instability: a review of the literature. Arthroscopy. 2002;18:912-24. https://doi.org/10.1053/jars.2002.36148

Kazel MD, Sekiya JK, Greene JA, et al. Percutaneous correction (humeroplasty) of humeral head defects (Hill-Sachs) associated with anterior shoulder instability: a cadaveric study. Arthroscopy. 2005;21:1473-8. https://doi.org/10.1016/j.arthro.2005.09.004

Finkelstein JA, Waddell JP, O'Driscoll SW, Vincent G. Acute posterior fracture dislocations of the shoulder treated with the Neer modification of the McLaughlin procedure. J Orthop Trauma. 1995 Jun;9(3):190-3. https://doi.org/10.1097/00005131-199506000-00002

Keppler P, Holz U, Thielemann FW, Meinig R. Locked posterior dislocation of the shoulder: Treatment using rotational osteotomy of the humerus. J Orthop Trauma. 1994;8:286-92. https://doi.org/10.1097/00005131-199408000-00003

Barbier O, Ollat D, Marchaland JP, Versier G. Iliac bone-block autograft for posterior shoulder instability. Orthop Traumatol Surg Res. 2009;95:100-7. https://doi.org/10.1016/j.otsr.2008.09.008

Meuffels DE, Schuit H, Van Biezen FC, Reijman M, Verhaar JA. The posterior bone block procedure in posterior shoulder instability: a long-term follow-up study. J Bone Joint Surg Br. 2010;92:651-5. https://doi.org/10.1302/0301-620X.92B5.23529

Spencer Jr E, Brems JJ. A simple technique for management of locked posterior shoulder dislocations: Report of two cases. J Shoulder Elbow Surg. 2005;14:650-2. https://doi.org/10.1016/j.jse.2004.11.008

Rowe CR, Zarins B. Chronic unreduced dislocations of the shoulder. J Bone Joint Surg Am. 1982;64:494-505. https://doi.org/10.2106/00004623-198264040-00004

Krackhardt T, Schewe B, Albrecht D, Weise K. Arthroscopic fixation of the subscapularis tendon in the reverse Hill-Sachs lesion for traumatic unidirectional posterior dislocation of the shoulder. Arthroscopy. 2006 Feb;22(2):227.e1-227.e6. https://doi.org/10.1016/j.arthro.2005.10.004

Bock P, Kluger R, Hintermann B. Anatomical reconstruction for reverse Hill-Sachs lesions after posterior locked shoulder dislocation fracture: a case series of six patients. Arch Orthop Trauma Surg. 2007;127:543-8. https://doi.org/10.1007/s00402-007-0359-y

Kropf EJ, Sekiya JK. Osteoarticular allograft transplantation for large humeral head defects in glenohumeral instability. Arthroscopy. 2007;23:322.e1-e5. https://doi.org/10.1016/j.arthro.2006.07.032

Engel T, Lill H, Korner J, Josten C. Bilateral posterior fracturedislocation of the shoulder caused by an epileptic seizure - diagnostic, treatment and result. Unfallchirurg. 1999;102:897- 901. https://doi.org/10.1007/s001130050499

Gerber C, Lambert SM. Allograft reconstruction of segmental defects of the humeral head for the treatment of chronic locked posterior dislocation of the shoulder. J Bone Joint Surg Am. 1996;78:376-82. https://doi.org/10.2106/00004623-199603000-00008

Konig DP, Rutt J, Treml O, Kausch T, Hackenbroch MH. Osteoarthrosis following the Putti-Platt operation. Arch Orthop Trauma Surg. 1996;115:231-2. https://doi.org/10.1007/BF00434561

Loebenberg MI, Cuomo F. The treatment of chronic anterior and posterior dislocations of the glenohumeral joint and associated articular surface defects. Orthop Clin. 2000;31:23-34. https://doi.org/10.1016/S0030-5898(05)70125-5

Banerjee S, Singh VK, Das AK, et al. Anatomical reconstruction of reverse Hill-Sachs lesions using the underpinning technique. Healio.com. 2012;35. https://doi.org/10.3928/01477447-20120426-35

Published

2014-06-20

How to Cite

1.
Jaramillo Fernández JC, Arismendi Montoya A, Duque Orozco M del P. Arthroscopic treatment of reverse Hill-Sachs injury avoiding internal fixation: Case report. Rev. Colomb. Ortop. Traumatol. [Internet]. 2014 Jun. 20 [cited 2025 May 10];28(2):69-75. Available from: https://revistasccotorg.biteca.online/index.php/rccot/article/view/465

Issue

Section

Case report