POSTER ABSTRACTS - ISAKOS

E-poster #914
Simultaneous Bilateral Posterior Dislocation of
the Shoulder: Case Report
Michael Ilias Iosifidis, Thessaloniki, GREECE,
Presenter
Leonidas Malioufas, Naoussa, GREECE
John Giannoulis, Naoussa, GREECE
Peter Sarriggiannidis, Naoussa, GREECE
Konstantinos Antoniou, Naoussa, GREECE
Konstantinos Tomtsis, Naoussa, GREECE
Stavros Traios Naoussa GREECE
George Giantsis Naoussa GREECE
Orthopaedic Department, Naoussa, GREECE
Posterior dislocation of the shoulder is rare injury.
In a literature review including 8140 cases of
shoulder dislocations, there were only 139
patients (1,7%) with posterior dislocation of the
shoulder reported. Simultaneous bilateral
posterior dislocation of the shoulder is even rarer.
It is also of special interest because most are
missed on the initial examination. Despite the
presence of pain, swelling and typical limitation of
motion, false initial diagnosis is mentioned in
retrospective reviews in the literature in a rate of
50-80%. An epileptic seizure or an electric shock
usually causes posterior dislocation of the
shoulder.
We present the case of a 47-year-old patient with
simultaneous bilateral posterior dislocation of the
shoulder, after a possible epileptic fit. The
complete evaluation of the diagnosis needed
more x-rays views, such as an axillary and lateral
scapula views. But the bilateral dislocation and
the limitation of abduction made further x-ray
check impossible. So we used urgently a CT
tomographer and the CT scan showed the size and
the kind of the injury, a bilateral posterior
shoulder dislocation with an impression defect of
the humeral head. Under general anesthesia,
close reduction of the dislocation was done.
Posterior dislocation of the shoulder -especially
the bilateral one- is a very rare injury, which
demand careful clinical and radiological
evaluation, when the history describes electric
shock or convulsive seizure. It is usually
associated reverse Hill-Sachs lesion (an
impression defect of the anteromedial aspect of
the humeral head), which size determines the
treatment of the injury.
E-poster #915
Incidence of SLAP Lesions Associated with
Surgical Acromioclavicular Injuries
Jeremy Clyde Johnson, Van Nuys, CA, USA,
Mark H. Getelman, Simi Valley, CA USA ,Presenter
Stephen J Snyder, Van Nuys, CA USA
Ronald P. Karzel, Van Nuys, CA USA
Southern California Orthopedic Institute, Van
Nuys, CA, USA
Purpose:
The purpose of this paper is to study the
incidence of SLAP (Superior Labrum Anterior to
Posterior) lesions in patients undergoing
acromioclavicular (AC) joint reconstruction.
Type of Study:
Retrospective review.
Materials and Methods:
A retrospective chart review was performed on
patients who underwent an acromioclavicular
joint reconstruction along with concurrent
shoulder arthroscopy between 1990 and 2003.
Patients from three experienced shoulder
surgeons were included. 59 patients that
underwent a Weaver-Dunn reconstruction or one
of its variants were identified.
Results:
Of the 59 patients identified, 22 (37%) had
documented intraarticular pathology. 18 patients
(31%) had documented SLAP lesions and 8 (14%)
had other pathology. In those patients with SLAP
lesions, 10 patients (55%) had type I lesions, 3
(17%) had type II lesions, 3 (17%) had type III
lesions, and 2 (11%) had type IV lesions.
Debridement was performed for type I and III
SLAP lesions (14 patients, 78%) and repair was
performed for type II and IV SLAP lesions (4
patients, 22%). In addition to the SLAP pathology,
two rotator cuff tears were identified, with one
patient undergoing arthroscopic repair and the
other debridement of a partial tear.
Conclusion:
At our institution, we routinely perform
arthroscopy for patients undergoing AC joint
reconstructions, and concomitant pathology has
been identified frequently. The diagnosis of SLAP
pathology in patients with AC joint injury can be
difficult. The mechanisms of injury can be similar
and result in unrecognized superior labral
pathology in light of the AC injury. In our study,
18 patients (31%) had documented SLAP lesions
and 8 patients (14%) had other treatable shoulder
pathology. These lesions would not have been
discovered without the addition of shoulder
arthroscopy. Failure to diagnose intraarticular
pathology, particularly SLAP lesions, in patients