Ipsilateral posterior shoulder dislocation and sternoclavicular dislocation – case report

Česká verze

Authors: Ján Palčák ^1,2; Pavel Sedlák ¹; Igor Čižmář ^1,2
Authors place of work: Traumatology department of the University Hospital Olomouc ¹; Traumatologické oddělení Fakultní nemocnice Olomouc ¹; Faculty of Medicine of Palacky University in Olomouc ²; Lékařská fakulta Univerzity Palackého v Olomouci ²
Published in the journal: Úraz chir. 23., 2015, č.3

Summary

Objective:
The objective of this case report is to present the diagnostic and therapeutic procedure of a rare injury to the shoulder girdle in a middle-aged male patient.

Materials and methods:
The authors describe the diagnostic methods and type of surgery in 40 years old patient with acute injury to the right shoulder girdle. The patient was diagnosed with dorsal dislocation of the shoulder and sternoclavicular joint on the same side. The authors did not met with a similar injury combination in the li-terature. The therapeutic objective was treatment of both affected sites. The posterior shoulder dislocation was initially reduced under arthroscopic control, then mini-arthrotomy was performed to refix the subscapularis tendon using a Helix anchor which solved the impression fracture of the humeral head (similar to a reverse Hill-Sachs lesion). Sternoclavicular dislocation was treated by open reduction and fixation of the medial end of the cla-vicle in anatomical position to the sternum using Ortocord fibers. After surgery, the arm was fixed in a brace for four weeks, followed by physiotherapy.

Results:
The patient is 6 months after the injury and this treatment regime satisfied with limb function, he is neither limited in daily activities, nor at work or sports. Range of motion of the shoulder joint: flexion up to 170°, rotation (external-internal): 75°-0-45°, abduction 140°. Clavicles are symmetrical.

Conclusion:
The described method of treatment is a good option for this rare type of injury, which we recommend based on our modest experience.

Key words:
Posterior dislocation of the shoulder, posterior sternoclavicular dislocation, reverse Hill-Sachs lesion, bulb sign.

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