USING 3D PRINTING FOR OPEN REDUCTION OF CHRONIC POSTERIOR SHOULDER DISLOCATION (CASE FROM PRACTICE)

Authors

DOI:

https://doi.org/10.15674/0030-59872023493-97

Keywords:

Shoulder joint, posterior dislocation, Hill-Sachs impression fracture, 3D-modelin

Abstract

Objective. An example of the treatment of a patient with chronic posterior dislocation of the shoulder, previously operated on by the Latarge technique due to recurrence of anterior instability, is given. Methods. The patient presented with an old fixed posterior dislocation of the left shoulder joint, large bone defect of the front part of the head (reverse Hill-Sachs). The patient has already undergone 2 operations on the left shoulder due to chronic anterior dislocation of the humeral head: 2018 — arthroscopy and capsuloplasty according to Bankart; 2020 — arthrotomy with Latarje transposition (due to recurrence of anterior instability). The peculiarity of this case is a bone block with screws located on the front surface of the glenoid made a massive defect front part of the humeral head. Planning performed on the basis of a CT scan of the shoulder joint in the FreeformPlus program. Assessment of functioning performed on the QuickDASH and Constant scales. The results. To improve the performance of intraoperative osteoplasty of the defect, a plastic model of the humeral head was printed for simulating bone graft and osteosynthesis. According to the QuickDASH scale before the operation, the patient had 45 points, that is, a significant decrease in the function of the upper limb — constant discomfort, pain. After surgery for 2 days — 35 points, 6 weeks — 12, and 3 months. — 12 points, that is, the patientʼs quality of life has improved significantly. According to the Constant scale before the operation, there were 16 points, of which: pain — 6, household activity — 2, range of motion — 8. After surgery on the 2nd day, a total of 33 points: pain — 10, household activity — 7, range of motion (passive) — 16, after 6 weeks — 80 points, this result remained after 3 months. Conclusion. The use of three-dimensional planning and an individual tool greatly facilitated the main stages ofsurgical intervention in the case of chronic posterior dislocation of the humeral head and made it possible to quickly and conveniently prepare a bone graft and install it in the defect. The printed navigation made it possible to perform a stabilizing osteosynthesis, ensure high patient satisfaction and a good functional result.

Author Biographies

Maxim Golovakha, Zaporizhzhia State Medical University. Ukraine

MD, Prof. in Traumatology and Orthopaedics

Stanislav Bondarenko, Clinic «Motor Sich», Zaporizhzhia. Ukraine

MD

References

  1. Speer, K. P. (1995). Anatomy and pathomechanics of shoulder instability. Clinics in sports medicine, 14 (4), 751–760.
  2. Liavaag, S., Svenningsen, S., Reikerås, O. A., Enger, M., Fjalestad, T., Pripp, A. H., & Brox, J. I. (2011). The epidemiology of shoulder dislocations in Oslo. Scandinavian journal of medicine & science in sports, 21 (6), e334–e340.
  3. Yeap, J. S., Lee, D. J., Fazir, M., Borhan, T. A., & Kareem, B. A. (2004). The epidemiology of shoulder dislocations in Malaysia. The Medical journal of Malaysia, 59, 19–23.
  4. Rowe, C. R. (1956). Prognosis in dislocations of the shoulder. JBJS, 38(5), 957–977.
  5. McLaughlin, H. L., & MacLellan, D. I. (1967). Recurrent anterior dislocation of the shoulder II. A comparative study. Journal of Trauma, 7 (2), 191–201. https://doi.org/10.1097/00005373-196703000-00002.
  6. Kao, J. T., Chang, C. L., Su, W. R., Chang, W. L., & Tai, T. W. (2018). Incidence of recurrence after shoulder dislocation: a nationwide database study. Journal of Shoulder and Elbow Surgery, 27 (8), 1519–1525.
  7. Bushnell, B. D., Creighton, R. A., & Herring, M. M. (2008). Bony instability of the shoulder. Arthroscopy: The Journal of Arthroscopic & Related Surgery, 24 (9), 1061–1073.
  8. Dumont, G. D., Russell, R. D., & Robertson, W. J. (2011). Anterior shoulder instability: a review of pathoanatomy, diagnosis and treatment. Current reviews in musculoskeletal medicine, 4, 200–207.
  9. Ahlgren, S. A., Hedlund, T., & Nistor, L. (1978). Idiopathic posterior instability of the shoulder joint: results of operation with posterior bone graft. Acta Orthopaedica Scandinavica, 49 (6), 600–603.
  10. Provencher, M. T., LeClere, L. E., King, S., McDonald, L. S., Frank, R. M., Mologne, T. S., ... & Romeo, A. A. (2011). Posterior instability of the shoulder: diagnosis and management. The American Journal of Sports Medicine, 39 (4), 874–886.
  11. Bigliani, L. U., Weinstein, D. M., Glasgow, M. T., Pollock, R. G., & Flatow, E. L. (1995). Glenohumeral arthroplasty for arthritis after instability surgery. Journal of Shoulder and Elbow Surgery, 4 (2), 87–94.
  12. Paparoidamis, G., Iliopoulos, E., Narvani, A. A., Levy, O., Tsiridis, E., & Polyzois, I. (2021). Posterior shoulder fracture-dislocation: A systematic review of the literature and current aspects of management. Chinese Journal of Traumatology, 24 (01), 18–24.
  13. Longo, U. G., Ciuffreda, M., Locher, J., Casciaro, C., Mannering, N., Maffulli, N., & Denaro, V. (2020). Posterior shoulder instability: a systematic review. British Medical Bulletin, 134 (1), 34–53.

Downloads

How to Cite

Golovakha, M., & Bondarenko, S. . (2024). USING 3D PRINTING FOR OPEN REDUCTION OF CHRONIC POSTERIOR SHOULDER DISLOCATION (CASE FROM PRACTICE). ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS, (4), 93–97. https://doi.org/10.15674/0030-59872023493-97

Issue

No. 4 (2023)

Section

SHORT REPORTS AND NEWS FROM PRACTICE

License

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

The authors retain the right of authorship of their manuscript and pass the journal the right of the first publication of this article, which automatically become available from the date of publication under the terms of Creative Commons Attribution License, which allows others to freely distribute the published manuscript with mandatory linking to authors of the original research and the first publication of this one in this journal.

Authors have the right to enter into a separate supplemental agreement on the additional non-exclusive distribution of manuscript in the form in which it was published by the journal (i.e. to put work in electronic storage of an institution or publish as a part of the book) while maintaining the reference to the first publication of the manuscript in this journal.

The editorial policy of the journal allows authors and encourages manuscript accommodation online (i.e. in storage of an institution or on the personal websites) as before submission of the manuscript to the editorial office, and during its editorial processing because it contributes to productive scientific discussion and positively affects the efficiency and dynamics of the published manuscript citation (see The Effect of Open Access).