Transfer of the lesser tuberosity for reverse Hill-Sachs lesions after neglected posterior dislocations of the shoulder: A retrospective clinical study of 13 cases

Acta Orthop Traumatol Turc. 2017 Oct;51(5):362-366. doi: 10.1016/j.aott.2017.07.004. Epub 2017 Aug 26.

Abstract

Objective: This study aimed to present middle-term functional and radiological outcomes of the transfer of the lesser tuberosity in the management of reverse Hill-Sachs lesions following posterior dislocations of the shoulder.

Patients and methods: With a diagnosis of neglected posterior shoulder dislocation (8 locked, 5 recurrent), 13 male patients (age range: 28-72; mean age: 39.3 years) who underwent the transfer of the lesser tuberosity due to reverse Hill-Sachs lesions, were retrospectively reviewed based on functional and radiological data. The etiologies were: epilepsy in 9 patients, a traffic accident in 2 patients, and fall in 2 patients. To assess the patients' functional level, American Shoulder and Elbow Surgeons (ASES) and Constant Scores were used, and the patients' range of motion at the last follow-up was measured. To evaluate the development of arthrosis, the final follow-up control plain radiographs were examined. The average size of the defects calculated from the axial computed tomography sets was 27% (range: 20%-40%).

Results: The average length of follow-up was 30 months (range: 12-67 months). At the last follow-up visit, the main ASES and Constant Scores were 78 and 85, respectively, and the average degrees of flexion, abduction, and external rotation were 163°, 151°, and 70° respectively. The concentric reduction was observed postoperatively.

Conclusion: McLaughlin procedure appears to be a safe and effective method in the treatment of neglected posterior shoulder dislocations with reverse Hill-Sachs lesion.

Level of evidence: Level IV, Therapeutic study.

Keywords: McLaughlin procedure; Posterior shoulder dislocation; Reverse Hill-Sachs lesion; Transfer of the lesser tuberosity.

MeSH terms

  • Adult
  • Bankart Lesions / complications*
  • Female
  • Follow-Up Studies
  • Humans
  • Humerus / diagnostic imaging
  • Humerus / surgery*
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care
  • Range of Motion, Articular
  • Recovery of Function
  • Retrospective Studies
  • Shoulder Dislocation* / diagnosis
  • Shoulder Dislocation* / physiopathology
  • Shoulder Dislocation* / surgery
  • Shoulder Joint* / diagnostic imaging
  • Shoulder Joint* / physiopathology
  • Shoulder Joint* / surgery
  • Tendon Transfer* / methods
  • Tendon Transfer* / rehabilitation
  • Tomography, X-Ray Computed / methods