Key result
A 39-year-old male experienced recurrent seizure-related posterior shoulder dislocations 13 years after a McLaughlin type remplissage procedure, demonstrating continued laxity.
Why the study?
Posterior shoulder dislocation diagnosis is often missed or delayed leading to complications, and success rates for surgical treatment options like the reverse remplissage procedure remain controversial.
Case Report (n=1)
No
This case highlights the potential for recurrent posterior shoulder instability and subluxation following a modified McLaughlin type (reverse remplissage) procedure, particularly in patients with chronic seizures.
Answers are grounded in this paper and cite their sources.
Recurrent instability may persist after reverse remplissage in seizure patients; leaves open questions on long-term durability and adjunct strategies.
Posterior shoulder dislocation is an uncommon injury that typically follows intense contraction of the external rotator muscles, such as from seizure activity, high-velocity trauma, or intense electrical shock. The diagnosis is often missed or delayed, leading to complications such as functional deficits or osteonecrosis of the humeral head. Closed reduction can be utilized following an initial occurrence, however, repeated insult to the glenohumeral joint may lead to posterior instability. A reverse Hill-Sachs lesion, a vertical impacted fracture of the anteromedial aspect of the humeral head, can occur. Surgical treatment options for posterior instability include the modified McLaughlin procedure also known as the reverse remplissage procedure. Unfortunately, the success rates of this procedure are controversial.
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Engel et al. (2020) conducted a case report in Recurrent Shoulder Posteroinferior Subluxation (n=1). McLaughlin type remplissage procedure was evaluated on Recurrent posterior shoulder dislocation. A 39-year-old male experienced recurrent seizure-related posterior shoulder dislocations 13 years after a McLaughlin type remplissage procedure, demonstrating continued laxity.
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