Posterior Shoulder Dislocation: About a Case and Literature Review

Abstract

Posterior glenohumeral dislocation is a rare entity representing less than 3% of all shoulder dislocations. The main etiologies are direct or indirect trauma, seizures and electrocution. Due to clinical signs that are sometimes not very obvious compared to the anterior dislocation and inadequate radiological assessments, the diagnosis is missed in 50 to 80% of cases during the initial presentation. The non-diagnosis of a posterior dislocation most often results in a stiff and painful shoulder settling in chronicity. If the cause is not recognized, which is unfortunately too often the case, many useless rehabilitation and physiotherapy sessions ensue, or even the initiation of alternative medicine with, as a result, the loss of sports and, more seriously, professional activity. Other disabling complications are to be feared, in particular the appearance of glenohumeral instability with episodes of recurrent posterior dislocations, an osteoarthritis model or avascular necrosis of the humeral head. These situations are avoidable if the diagnosis is made from the outset because remedying them, after sometimes-long delays (several months), requires complex surgical reconstruction with a variable success rate. The purpose of this article is therefore to highlight and clarify the challenges and pitfalls presented by posterior shoulder dislocation, its diagnosis and management.