The clinical and functional outcomes of closed reduction and arthroscopic McLaughlin procedure in patients with neglected locked posterior shoulder dislocation.

Abstract

Posterior shoulder dislocation with a reverse Hill-Sachs lesion is a rare and complex injury, requiring specialized treatment due to the difficulty in diagnosis, reduction, and addressing both sides of the pathology to reduce the potential for recurrent dislocation. To evaluate the clinical and functional outcomes of closed reduction and arthroscopic McLaughlin procedure with posterior labral repair in patients with neglected locked posterior shoulder dislocation for less than 12 weeks. A prospective study was conducted at university hospitals, managing 15 patients with neglected locked posterior shoulder dislocation for less than 12 weeks and concomitant engaging reverse Hill-Sachs lesions of less than 40% of the humeral articular surface. They were treated with closed reduction and arthroscopic McLaughlin procedure with posterior labral repair. Patients' assessments included shoulder range of motion, pain levels using the visual analog scale (VAS) score, and functional outcome using the Oxford instability score and the University of California Los Angeles Shoulder Scale (UCLA) with at least 2years of postoperative follow-up. All 15 patients reported no recurrent dislocation and restored shoulder motion at the final follow-up. External rotation significantly improved from 0° to a mean of 65° in adduction, at 90° of abduction, the respective measurement was 85° (p<0.01). Active forward flexion increased from 35° to 145° (p<0.01). UCLA and Oxford instability scores Showed marked improvement (p<0.01). Closed reduction and arthroscopic McLaughlin procedure with posterior labral repair is a safe and effective way for managing patients with locked neglected posterior shoulder dislocations that have been neglected for less than 12 weeks with engaging reverse Hill-Sachs lesion defect, less than 40% of the humeral head.