| Objective To explore the therapeutic strategy of posterior shoulder dislocation and anti-Hill-Sachs injury. Methods A total of 14 cases with posterior shoulder dislocation and anti-Hill-Sachs injury were selected from January 2010 to January 2017．Causes of trauma: fall in 4 cases, road traffic injuries in 6 cases, electrical injury in 3 cases, epilepsy in 1 case; simple dislocation in 8 cases, fracture-dislocation in 6 cases; acute injury (<6 weeks) in 11 cases, chronic injury (> 6 weeks) in 3 cases; in 10 cases, the defect of the anterior edge of the humeral head was less than 25%, 3 cases had a defect of about 30%, and 1 case had a defect of about 40%. All patients used pectoralis major muscle deltopectoral surgical approach, "L"-shaped incision of the subscapularis muscle, open the "golden path" and fixed under direct vision, among which one case was fixed by rivet insertion and had its joint capsule repaired, 7 cases were fixed by screws, 6 by locking compression plate and screws. Results All 14 patients were followed up for 12 to 54 months, with an average of 18.3 months. At the last review, all patient incisions healed in one stage and the fractures healed well. One case of postoperative reexamination showed that the X-ray film showed good tibiofibular fracture, and the humeral head was displaced to the posterior subluxation. The shoulder mobility at the last follow-up was about 80° for flexion and 30° for external rotation. The other 13 patients were treated with surgery. After X-ray examination, the fractures were well aligned and the ankle joints were well matched. There were no complications such as recurrence and dislocation and humeral head necrosis. The flexion of the shoulder joint ranged from 90° to 165°, with an average of 142°. The range is 15°～40°, with an average of 35°; the range of abduction is 80°～165°, with an average of 143°; according to the degree of shoulder pain, daily life impact, active range and muscle strength at the last follow-up, refer to the Constants scoring standard: excellent in 5 cases, good in 7 cases, medium in 2 cases, the excellent and good rate was 85.71%. Conclusion Surgical treatment of posterior shoulder dislocation and anti-Hill-Sachs injury has satisfactory clinical outcomes. Early diagnosis and early surgical treatment can effectively improve shoulder function. |
