ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2019
The dual subscapularis procedure: a modified Hawkins' technique for neglected posterior fracture/dislocation of the shoulder.
Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed, 9 citations in OpenAlex.
- The duration of dislocation is the most important prognostic factor in chronic locked posterior shoulder dislocations treated with the modified McLaughlin surgical procedure: a multicentre study.BMC musculoskeletal disorders · 2025Article
- A novel modified McLaughlin surgery for treating locked chronic posterior shoulder dislocation.BMC musculoskeletal disorders · 2023Article
- Good functional results with open reduction and internal fixation for locked posterior shoulder fracture-dislocation: a case series.Clinics in shoulder and elbow · 2022Article
- Chronic locked posterior gleno-humeral dislocation: technical note on fibular grafting for restoration of humeral head sphericity.Journal of orthopaedic surgery and research · 2021Article
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2 authors at 2 institutions in 1 country.
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Abstract
backgroundPosterior fracture/dislocation of the shoulder is a rare injury that is frequently missed on initial assessment. It is frequently associated with reverse Hill-Sachs impression fracture. Several orthopaedics procedures have been described on the literature for reconstructable reverse Hill-Sachs lesion. The McLaughlin's procedure and its modifications, anatomic bone grafting procedures, rotational osteotomies, and the remplissage technique were reported by many authors. We advocated a new "dual subscapularis procedure" that consists of the Hawkins lesser tuberosity transfer with addition of filling the remainder of the defect with a part of subscapularis tendon. MATERIALS AND
methodsIn the period between January 2013 to December 2017, 12 patients (13 shoulders) suffering from a delayed managed posterior fracture dislocation were managed. Our inclusion criteria were adult patients less than 60 years presented with reverse Hill-Sachs impression defects from 20 to 50% with or without fractures. For all patients, the dual subscapularis procedure was done. UCLA score was used for postoperative functional assessment.
resultsAfter a minimum follow-up of 6 months, the results of UCLA score were excellent/good in eight patients and fair/poor in five patients. All patients were found stable after open reduction ± internal fixation with no reported complications. There was a significant correlation of the UCLA score and non-abuse or lower doses of tramadol and the shorter interval between trauma and procedure. Twelve patients were satisfied after the operation.
conclusionReconstructing the reverse Hill-Sachs defect with the dual subscapularis technique provides adequate stability, pain relief, and function in patients with locked chronic posterior shoulder fracture/dislocation. The used technique has the merit of versatility with different fracture patterns, improved fixation of the tendon and increasing the tendon's footprint that ensures extra-articular location of the defect. LEVEL OF EVIDENCE: II.
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