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The Journal of Bone and Joint Surgery 81:708-10 (1999)
© 1999 The Journal of Bone and Joint Surgery, Inc.

Missed Posterior Fracture-Dislocation of the Humeral Head. A Case Report with a Fifteen-Year Follow-up After Delayed Open Reduction and Internal Fixation*

T. KENNETH KAAR, M.D.{dagger}, MICHAEL A. WIRTH, M.D.{dagger} and CHARLES A. ROCKWOOD, JR., M.D.{dagger}, SAN ANTONIO, TEXAS

Investigation performed at the Shoulder Service, Department of Orthopaedics, University of Texas Medical School and Health Science Center, San Antonio


   Introduction
 
Posterior fracture-dislocation of the humeral head is an uncommon and frequently missed injury of the shoulder. A delay in diagnosis may increase the risk of osteonecrosis and subsequent collapse of the humeral head. Some authors have advocated routine primary replacement of the humeral head with a prosthesis for these injuries, particularly if there has been a delay in treatment4. We describe the case of a patient who had a late diagnosis of a two-part fracture-dislocation of the anatomical neck of the humerus. The fracture was treated with open reduction and internal fixation, and the patient had no evidence of segmental collapse of the humeral head at the time of the fifteen-year follow-up.


   Case Report
 
A twenty-two-year-old, right-hand-dominant man was seen in the emergency department of a large hospital after he was involved in a motorcycle accident. The patient was managed for multiple injuries, including a head injury with loss of consciousness, . . . [Full Text of this Article]


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G. F. Dervin, J. A. Brunet, and D. C. Healey
A Modification of the McLaughlin Procedure as Salvage for Missed Locked Posterior Fracture-Dislocation of the Humeral Head : A Case Report
J. Bone Joint Surg. Am., May 1, 2002; 84(5): 804 - 807.
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