Fracture sequelae type2 of the proximal humerus-clinical results after arthroplasty

Abstract

Locked dislocations of the glenohumeral joint are rare but often painful and are associated with limited range of motion in the shoulder. In patients of advanced age, arthroplasty is increasingly indicated as asurgical treatment option. Preoperatively, the direction of dislocation, the presence and extent of aglenoid defect, and the soft tissue situation (rotator cuff status, joint capsule) should be analyzed in adifferentiated manner. Based on the above factors, we recommend the subclassification of type2 according to Boileau: posterior locked dislocation (2a), anterior locked dislocation without glenoid defect (2b), and anterior locked dislocation with glenoid defect (2c). In the case of dorsally locked dislocation, agood clinical result can be achieved by using an anatomical endoprosthesis. For ventrally locked dislocations, we recommend using an inverse total endoprosthesis with, if necessary, bony glenoid reconstruction and transfer of the pectoralis major muscle.Level of evidence: IV.