TREATMENT OF LOCKED POSTERIOR FRACTURE-DISLOCATIONS OF THE SHOULDER BY TOTAL SHOULDER ARTHROPLASTY

Total shoulder arthroplasty is indicated in the treatment of locked po sterior fracture-dislocations of the shoulder where there is extensive damage to the articular surfaces of the humerus and glenoid. This rep ort reviews the surgical technique, postoperative rehabilitation progr am, and functional results of seven shoulders in five patients who had locked posterior dislocations of the shoulder. Activities involving o verhead positioning of the arm and heavy lifting continued to be chall enging for this group of patients. The American Shoulder and Elbow Sur geons' Shoulder Score improved from 20.1 before surgery to 55.6 after surgery (p = 0.018). The extrication of the posteriorly dislocated hum eral head may be difficult From an anterior deltopectoral approach. Th e authors describe the use of a secondary posterior incision facilitat ing the extrication of the humeral head. In this series fetal shoulder arthroplasty reliably decreased the patients' level of pain, improved their range of motion, and significantly improved their level of func tion.