Treatment for delayed and chronic fracture dislocation of the shoulder

Abstract

Abstract Background Chronic fracture dislocation of the shoulder is really rare clinically. In the literature, treatment of these cases was barely discussed. Here, we review the results of this kind of cases treated at our hospital. Methods Nine patients with delayed or chronic fracture dislocation of the shoulder were treated at our hospital from February 2000 to April 2007. Three of them who received shoulder hemiarthroplasty were excluded from this study. The other six patients received procedures of open reduction and internal fixation with buttress plate and allografting at the fracture site. The average age of the six patients at the index surgery was 46.2 years. The average time between injury and treatment was 40 days. The average follow-up period was 10.4 months. Results Four patients with missed diagnosis and who received first time surgery had no pain over the involved shoulder and no limitation in the daily activities. They were all satisfied with the results. However, two patients with failed previous surgery got nonunion of the fracture site after the revision surgery. Conclusions For patients with misdiagnosed fracture dislocation of the shoulder, open reduction, internal fixation, and allografting can be performed if the articular cartilage is intact and a satisfactory result can be expected. However, for revision surgery, resorption of the fracture site may develop even with allografting and rigid fixation. Shoulder hemiarthroplasty is therefore a better treatment for these patients.