Parakh Naman K, Sharma Abhishek Ashok, Kumar S Krishna
Department of Orthopedics, Teerthanker Mahaveer Medical College and Research Centre, Moradabad, Uttar Pradesh, India.
J Orthop Case Rep. 2025 Aug;15(8):121-125. doi: 10.13107/jocr.2025.v15.i08.5908.
Chronic locked posterior dislocation (CLPD) of the shoulder presents a big challenge to the orthopedic surgeon due to the progressive damage to the glenohumeral articulation and increase in size of the reverse Hill-Sachs lesion (RHSL). Multiple treatment strategies have been postulated depending upon the size of the humeral head defect and the RHSL.
A 35-year-old Indian male patient presented to our Outpatient Department with complaints of pain and restriction in the range of motion over the right shoulder since suffering an injury over the shoulder 6 months back. Clinical examination revealed a bony restriction particularly in external rotation, flexion, and abduction of the right shoulder. The radiographs were suggestive of CLPD of the right shoulder with a large sized humeral head defect. An magnetic resonance imaging of the right shoulder was done to quantify the defect and reveal the anatomical status of the shoulder joint. After proper planning and workup, the patient was managed surgically with the modified McLaughlin procedure. Proper rehabilitation and regular follow-ups were done and the patient showed significant functional improvement of the right shoulder at 2-year follow-up.
The treatment of CLPD varies according to the size of the humeral head defect and the functional demand of the patient. The modified McLaughlin procedure is an excellent option in mild to moderate-sized defects. The results of the procedure are also affected by the delay in treatment since the time of injury.
肩部慢性锁定后脱位（CLPD）对骨科医生而言是一项巨大挑战，因为它会对盂肱关节造成渐进性损害，并使反Hill-Sachs损伤（RHSL）的面积增大。根据肱骨头缺损的大小和RHSL，已提出多种治疗策略。
一名35岁的印度男性患者因6个月前肩部受伤后出现右肩部疼痛及活动范围受限，前来我院门诊就诊。临床检查发现存在骨阻滞，尤其是右肩部的外旋、屈曲和外展受限。X线片提示右肩部CLPD，伴有较大尺寸的肱骨头缺损。对右肩部进行磁共振成像检查，以量化缺损并揭示肩关节的解剖状况。经过适当的规划和检查后，采用改良McLaughlin手术对患者进行了手术治疗。进行了适当的康复治疗和定期随访，在2年随访时患者右肩部功能有显著改善。
CLPD的治疗因肱骨头缺损大小和患者功能需求而异。改良McLaughlin手术对于轻至中度缺损是一个极佳选择。该手术的结果也会受到受伤后治疗延迟的影响。
