Focus on recurrent shoulder dislocation

  There has been an increased emphasis on initial glenohumeral dislocations overseas, and many surgeons advocate minimally invasive arthroscopic surgery for initial glenohumeral dislocations caused by trauma. For domestic patients, surgical treatment of initial glenohumeral dislocation is often difficult to accept, so domestic physicians generally advocate surgical treatment for recurrent glenohumeral dislocations due to trauma. However, some patients with recurrent glenohumeral dislocations after trauma are still reluctant to undergo surgery, which not only leads to a serious impact on their lives, but also causes bone defects due to repeated dislocations, which ultimately makes surgical treatment very difficult.  Last year we met a 70-year-old woman who had a traumatic glenohumeral dislocation a few years ago and had been dislocated once a month on average since then, and had to go to the hospital for manual repositioning each time. At the time of the patient’s visit, we found a scaphoid glenoid defect with severe compression of the posterior lateral articular surface of the humeral head by 3D CT of the shoulder joint (see Figures 1,2), so it was no longer suitable for arthroscopic soft tissue surgery alone, and we performed an arthroscopic Remplissage combined with an open Latarjet procedure (Figures 3,4,5), which allowed the patient to regain stability of the glenohumeral joint.  Therefore, we recommend that patients with traumatic recurrent glenohumeral dislocations receive timely treatment with minimally invasive arthroscopic surgery.  Figure 1 Posterior lateral humeral head compression fracture Figure 2 Posterior lateral humeral head compression fracture with scaphoid glenoid defect Figure 3, 4 Scaphoid glenoid defect filled after Lartarjet Figure 5 Posterior lateral humeral head compression with soft tissue filling after Remplissage