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Locked fracture dislocations of the proximal humerus: postoperative results and a proposed modification of the classification

Zitieren Sie bitte immer diese URN: urn:nbn:de:bvb:20-opus-268454
  • 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 HandBackground 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.zeige mehrzeige weniger

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Metadaten
Autor(en): Jonas Schmalzl, Annika Graf, Fabian Gilbert, Michael Kimmeyer, Christian Gerhardt, Lars-Johannes Lehmann
URN:urn:nbn:de:bvb:20-opus-268454
Dokumentart:Artikel / Aufsatz in einer Zeitschrift
Institute der Universität:Medizinische Fakultät / Klinik und Poliklinik für Unfall-, Hand-, Plastische und Wiederherstellungschirurgie (Chirurgische Klinik II)
Sprache der Veröffentlichung:Englisch
Titel des übergeordneten Werkes / der Zeitschrift (Englisch):European Journal of Orthopaedic Surgery & Traumatology
ISSN:1432-1068
Erscheinungsjahr:2022
Band / Jahrgang:32
Heft / Ausgabe:4
Seitenangabe:683–692
Originalveröffentlichung / Quelle:European Journal of Orthopaedic Surgery & Traumatology 2022, 32(4):683–692. DOI: 10.1007/s00590-021-03022-z
DOI:https://doi.org/10.1007/s00590-021-03022-z
PubMed-ID:https://pubmed.ncbi.nlm.nih.gov/34089131
Allgemeine fachliche Zuordnung (DDC-Klassifikation):6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Freie Schlagwort(e):bone defect; fracture sequelae shoulder; glenoid bonegrafting; locked shoulder dislocation; pectoralis major transfer; shoulder arthroplasty
Datum der Freischaltung:08.06.2022
Lizenz (Deutsch):License LogoCC BY: Creative-Commons-Lizenz: Namensnennung 4.0 International