Article

The main objective of this study is to describe a new surgical
technique that, through a gleno-humeral approach, reduces the incongruent joint
while a humeral head centering osteotomy achieves shoulder stabilization. A
humeral medial derotational osteotomy is performed associated with the articular
reduction. METHODS: Fourteen patients with obstetrical palsy
presenting a posterior humeral head dislocation were submitted to a centering
osteotomy procedure. Our study included patients with: (1) more than 1.5years
postoperative follow-up, (2) presence of humeral head posterior dislocation. The
exclusion criteria were the following: (1) patients with total flaccid paralysis,
(2) low paralysis and (3) any kind of active infection at the time of the
procedure. RESULTS: Before treatment, in all patients, the shoulder joint was
posteriorly dislocated and in internal rotation. All patients went on to have
successful healing at the osteotomy site. In all cases, an improvement in the
functional Mallet scale was observed. In all patients, except one, the posterior
dislocation was corrected. In two cases, a second surgery (external derotation
osteotomy) was performed to improve the upper extremity's position. CONCLUSIONS:
Articular congruency, after posterior dislocations of the humeral head, is
achieved by humeral head centering osteotomy in patients with obstetrical palsy
late deformities and also improves function. EVIDENCE: Level IV; case series.
CI - Copyright (c) 2012. Published by Elsevier Masson SAS.

Langue : ANGLAIS

Tiré à part : OUI