Treatment of Chronic Locked Posterior Dislocation of the Shoulder: Is There a Time Limit to Try a Closed Reduction?

CASE: Three patients with chronic locked posterior shoulder dislocation diagnosed 4 to 10 weeks after injury, each with a reverse Hill-Sachs lesion involving >25% of the humeral head, underwent closed reduction under general anesthesia using the "2 thumbs" technique, followed by immobilization in external rotation. CONCLUSION: At a mean 4-year follow-up, all had excellent function without recurrent instability, avascular necrosis, or osteoarthritis. In carefully selected patients, closed reduction remains a safe and effective option beyond the 3-week time frame, when surgery is traditionally recommended.