[Undetected traumatic posterior glenohumeral dislocation]. 2017

J A Rosas-Medina
Servicio de Traumatología del Hospital General Regional Núm. 2 del Instituto Mexicano del Seguro Social (IMSS). Ciudad de México. México.

BACKGROUND Glenohumeral dislocation (GHD) is frequent, but traumatic posterior glenohumeral dislocation (TPGHD) is rare, with an incidence of 1-4% of all GHD. The diagnosis is a challenge: sometimes, it can be omitted due to incorrect diagnosis, absence of consideration in the differential diagnosis, suboptimal radiographic evaluation and an absence of characteristic signs and symptoms; missed diagnosis reaches 60-79% and the diagnosis can delay from 24 hours to a year. OBJECTIVE To transmit previous experiences to provide support for better diagnosing TPGHD, favoring appropriate attention. METHODS Case 1. 34-year-old male. Delayed diagnosis of left TPGHD in the 4th week. Reverse Hill-Sachs < 25%. Closed reduction, immobilization for four weeks. Follow-up at week 20, good functional recovery (UCLA = 32). Case 2. 32-year-old male. Eight months with undiagnosed left TPGHD. Reverse Hill-Sachs 25%. Open reduction, immobilization for four weeks. Eight-month post-surgical follow-up. Good functional recovery (UCLA = 29). CONCLUSIONS The diagnosis of TPGHD is difficult because of its lack of frequency. Even with delayed diagnosis-treatment, evolution can be favorable provided that the reverse Hill-Sachs injury is 25% or minor. To avoid a delayed diagnosis and inadequate attention, we must always consider the injury mechanism, physical examination with the arm fixed in internal rotation, clinical suspicion in functional deficit for external rotation, flexion and abduction, radiographic studies including true AP and scapula lateral (Y view).

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D008297 Male Males
D010808 Physical Examination Systematic and thorough inspection of the patient for physical signs of disease or abnormality. Physical Exam,Examination, Physical,Physical Examinations and Diagnoses,Exam, Physical,Examinations, Physical,Exams, Physical,Physical Examinations,Physical Exams
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012783 Shoulder Dislocation Displacement of the HUMERUS from the SCAPULA. Glenohumeral Dislocation,Glenohumeral Subluxation,Dislocation, Glenohumeral,Dislocation, Shoulder,Dislocations, Glenohumeral,Dislocations, Shoulder,Glenohumeral Dislocations,Glenohumeral Subluxations,Shoulder Dislocations,Subluxation, Glenohumeral,Subluxations, Glenohumeral
D016059 Range of Motion, Articular The distance and direction to which a bone joint can be extended. Range of motion is a function of the condition of the joints, muscles, and connective tissues involved. Joint flexibility can be improved through appropriate MUSCLE STRETCHING EXERCISES. Passive Range of Motion,Joint Flexibility,Joint Range of Motion,Range of Motion,Flexibility, Joint
D019651 Plastic Surgery Procedures Procedures used to reconstruct, restore, or improve defective, damaged, or missing structures. Cosmetic Reconstructive Surgical Procedures,Cosmetic Surgical Procedures,Esthetic Reconstructive Surgical Procedures,Esthetic Surgical Procedures,Plastic Surgical Procedures,Reconstructive Surgical Procedures,Reconstructive Surgical Procedures, Cosmetic,Cosmetic Reconstructive Surgery,Procedure, Reconstructive Surgical,Procedures, Reconstructive Surgical,Reconstructive Surgical Procedure,Reconstructive Surgical Procedures, Esthetic,Surgical Procedure, Reconstructive,Surgical Procedures, Reconstructive,Cosmetic Reconstructive Surgeries,Cosmetic Surgical Procedure,Esthetic Surgical Procedure,Plastic Surgery Procedure,Plastic Surgical Procedure,Procedure, Cosmetic Surgical,Procedure, Esthetic Surgical,Procedure, Plastic Surgery,Procedure, Plastic Surgical,Procedures, Cosmetic Surgical,Procedures, Esthetic Surgical,Procedures, Plastic Surgery,Procedures, Plastic Surgical,Reconstructive Surgeries, Cosmetic,Reconstructive Surgery, Cosmetic,Surgeries, Cosmetic Reconstructive,Surgery Procedure, Plastic,Surgery Procedures, Plastic,Surgery, Cosmetic Reconstructive,Surgical Procedure, Cosmetic,Surgical Procedure, Esthetic,Surgical Procedure, Plastic,Surgical Procedures, Cosmetic,Surgical Procedures, Esthetic,Surgical Procedures, Plastic
D020127 Recovery of Function A partial or complete return to the normal or proper physiologic activity of an organ or part following disease or trauma. Function Recoveries,Function Recovery

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