Service d'Orthopédie, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada.
J Orthop Trauma. 2012 Apr;26(4):246-51. doi: 10.1097/BOT.0b013e3182243909.
Posterior shoulder dislocations are rare and often missed. Classically associated with seizures, very little is known about the incidence and type of associated injuries. Unfortunately, the majority of the literature consists of incidental reports or small case series. Our goal was to increase the strength of available data by performing a systematic review.
We searched EMBASE and PubMed for the terms "posterior shoulder dislocation." Our inclusion criteria were articles in either English or French with the words "posterior" and "dislocation" in the abstract or title. All reports of chronic cases or instability as well as those without patient information were excluded. Data regarding demographics, etiology, investigations, associated injuries, treatments, and outcomes were extracted. All data were analyzed by using SPSS 18.0 (IBM, Chicago, IL).
A total of 766 articles were found of which 108 were retained for analysis. A total of 475 patients (543 shoulders) were compiled. Seizures were reported in 34% of cases. A majority of dislocations (65%) had associated injuries. Fracture was most common followed by reverse Hill-Sachs and cuff tears. In the absence of fracture or reverse Hill-Sachs injury, the risk of cuff tear increased nearly fivefold (odds ratio, 4.6; P = 0.016).
Our results suggest the amount of associated injuries related to posterior shoulder dislocation is far greater than thought. We propose an investigation algorithm for acute posterior shoulder dislocations.
肩后脱位较为罕见，常被漏诊。该病与癫痫发作密切相关，但目前对其发病率和合并损伤类型知之甚少。遗憾的是，大部分文献均为偶然报告或小样本病例系列研究。我们旨在通过系统评价增加现有数据的可信度。
我们在 EMBASE 和 PubMed 中检索了“posterior shoulder dislocation”一词。纳入标准为英文或法文文献，摘要或标题中包含“posterior”和“dislocation”。排除慢性病例或不稳定病例以及无患者信息的报告。提取了关于人口统计学、病因、检查、合并损伤、治疗和结局的数据。所有数据均采用 SPSS 18.0（IBM，芝加哥，IL）进行分析。
共检索到 766 篇文章，其中 108 篇被保留用于分析。共纳入 475 例患者（543 个肩关节）。34%的病例报告有癫痫发作。大多数脱位（65%）合并有损伤。骨折最常见，其次是反向 Hill-Sachs 损伤和肩袖撕裂。在无骨折或反向 Hill-Sachs 损伤的情况下，肩袖撕裂的风险增加近 5 倍（比值比，4.6；P=0.016）。
我们的结果表明，肩后脱位相关合并损伤的数量远远超过人们的想象。我们提出了一种针对急性肩后脱位的检查算法。
