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

• Main Authors: Mehmet Demirel, Ali Erşen, Gökhan Karademir, Ata Can Atalar, Mehmet Demirhan
• Format: Article
• Language: English
• Published: AVES Yayincilik 2017-10-01
• Series: Acta Orthopaedica et Traumatologica Turcica
• Online Access: http://www.sciencedirect.com/science/article/pii/S1017995X17301736

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