TY  - JOUR
A1  - Schmalzl, Jonas
A1  - Graf, Annika
A1  - Gilbert, Fabian
A1  - Kimmeyer, Michael
A1  - Gerhardt, Christian
A1  - Lehmann, Lars-Johannes
T1  - Locked fracture dislocations of the proximal humerus: postoperative results and a proposed modification of the classification
JF  - European Journal of Orthopaedic Surgery & Traumatology
N2  - Background
Locked dislocations of the glenohumeral joint are disabling and often painful conditions and the treatment is challenging. This study evaluates the functional outcome and the different prosthetic treatment options for chronic locked dislocations of the glenohumeral joint and a subclassification is proposed.
Methods
In this single-center retrospective case series, all patients with a chronic locked dislocation treated surgically during a four-year period were analyzed. Constant score (CS), Quick Disabilities of Shoulder and Hand Score (DASH), patient satisfaction (subjective shoulder value (SSV)), revision rate and glenoid notching were analyzed.
Results
26 patients presented a chronic locked dislocation of the glenohumeral joint. 16 patients (62%) with a mean age of 75 [61-83] years were available for follow-up at 24 ± 18 months. CS improved significantly from 10 ± 6 points to 58 ± 21 points (p < 0.0001). At the final follow-up, the mean DASH was 27 ± 23 and the mean SSV was 58 ± 23 points. The complication rate was 19% and the revision rate was 6%; implant survival was 94%. Scapular notching occurred in 2 (13%) cases (all grade 1).
Conclusion
With good preoperative planning and by using the adequate surgical technique, good clinical short-term results with a low revision rate can be achieved. The authors suggest extending the Boileau classification for fracture sequelae type 2 and recommend using a modified classification to facilitate the choice of treatment as the suggested classification system includes locked posterior and anterior dislocations with and without glenoid bone loss.
KW  - glenoid bonegrafting
KW  - fracture sequelae shoulder
KW  - shoulder arthroplasty
KW  - locked shoulder dislocation
KW  - bone defect
KW  - pectoralis major transfer
Y1  - 2022
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-268454
SN  - 1432-1068
VL  - 32
IS  - 4
ER  -