Successful Treatment of Chronic, Locked Posterior Shoulder Dislocations in Young Trauma Patients with the Modified McLaughlin Procedure

Abstract

The objective of this study was to examine the functional outcome of the Neer and Hawkins modification of the McLaughlin procedure for chronic, locked posterior dislocations of the shoulder in young patients. A retrospective chart analysis was performed on six patients treated by a single orthopedic surgeon over an 11-year period. Complete medical records were available for four patients who were the subjects of this study. Each patient underwent a transfer of the lesser tuberosity into the anteromedial head defect (modified McLaughlin procedure), with subsequent immobilization and physical therapy. One patient required a staged rotational osteotomy with internal fixation 2 weeks after the index procedure. The mean age of the patients was 29.75 (range, 20–44), while the mean follow-up period was 12.5 months (range, 9–19 months). There was an average increase in abduction of 47°, an increase in forward flexion of 49°, an increase in external rotation of 23°, and an increase in internal rotation of 19°, when comparing the pre- and postoperative range of motion. Total UCLA scores post-operatively averaged 25.3 (range, 21–29) out of 35. All shoulders were stable without any episodes of redislocation at follow-up. This study supports the use of the Neer and Hawkins modification of the McLaughlin procedure in young patients with a chronic, locked posterior dislocation of the shoulder.