Surgery for locked posterior shoulder dislocation yields satisfactory results

Schliemann B. Arch Orthop Trauma Surg. Published online May 13, 2011. doi: 10.1007/s00402-011-1310-9.

Various surgical treatment options are capable of achieving satisfying results for locked posterior shoulder dislocation despite the uncommon — and frequently misdiagnosed — nature of the condition, according to German investigators.

“Early diagnosis by detailed clinical examination and sufficient radiographic evaluation with true anterior-posterior and axillary views is essential to improve clinical results,” the authors wrote.

The investigators examined 35 patients with locked posterior shoulder dislocation between January 1999 and August 2009. Twenty-nine of these patients underwent surgery, with the remaining six undergoing conservative treatment because their shoulders displayed stability after closed reduction.

After a mean follow-up of 55 months, the team found patients who were treated conservatively were able to achieve a Constant Score of 85 points. Patients who underwent operative treatment, according to the study abstract, had a “slightly worse” outcome, averaging 79 points.

A critical factor in overall outcome, the authors noted, was the interval between the initial trauma and the correct diagnosis of posterior shoulder dislocation. Average time between injury and diagnosis in the study was reported as 66 days.

“There was a high correlation between the time to correct diagnosis and the outcome,” the authors wrote.