Chronic locked posterior gleno-humeral dislocation: technical note on fibular grafting for restoration of humeral head sphericity

Abstract Background Reconstruction of reverse Hill-Sachs defect using osteo-chondral allograft has the advantages of spherical re-contouring and provision of smooth biological articular surface of the reconstructed humeral head. However, worldwide availability and risk of disease transmission of ost...

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Autor principal:	Amr Abdel-Mordy Kandeel
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Fibular grafting Humeral head reconstruction Locked gleno-humeral dislocation Posterior gleno-humeral dislocation Reverse Hill-Sachs defect Orthopedic surgery RD701-811 Diseases of the musculoskeletal system RC925-935
Acceso en línea:	https://doaj.org/article/39e4b1708c3e4ebbadcdefcd63a376cb
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spelling	oai:doaj.org-article:39e4b1708c3e4ebbadcdefcd63a376cb2021-11-21T12:30:00ZChronic locked posterior gleno-humeral dislocation: technical note on fibular grafting for restoration of humeral head sphericity10.1186/s13018-021-02835-21749-799Xhttps://doaj.org/article/39e4b1708c3e4ebbadcdefcd63a376cb2021-11-01T00:00:00Zhttps://doi.org/10.1186/s13018-021-02835-2https://doaj.org/toc/1749-799XAbstract Background Reconstruction of reverse Hill-Sachs defect using osteo-chondral allograft has the advantages of spherical re-contouring and provision of smooth biological articular surface of the reconstructed humeral head. However, worldwide availability and risk of disease transmission of osteo-chondral allograft remain points of increasing concerns. As an alternative to lacking osteo-chondral allograft, the current technical note describes a reconstructive technique of reverse Hill-Sachs defect using autologous fibular grafting. Methods Following open reduction of the dislocated humeral head, reverse Hill-Sachs defect was reconstructed using 3–4 autologous fibular pieces (each is of 10 mm in length) fixed in flush with the articular cartilage using 4-mm cancellous screws. Defect reconstruction was then followed by modified McLaughlin’s transfer and posterior capsulorrhaphy. Results Spherical contour of the humeral head and gleno-humeral range of motion were restored. Intra-operative dynamic testing of the reconstruct revealed no residual posterior gleno-humeral instability. Conclusion Currently reported technique might offer advantages of graft availability, technical simplicity, familiarity and reproducibility, safety (i.e. no disease transmission) and bone preservation facilitating future revision management (if needed). Nevertheless, long-term outcomes of this technique should be investigated via further cohort clinical studies.Amr Abdel-Mordy KandeelBMCarticleFibular graftingHumeral head reconstructionLocked gleno-humeral dislocationPosterior gleno-humeral dislocationReverse Hill-Sachs defectOrthopedic surgeryRD701-811Diseases of the musculoskeletal systemRC925-935ENJournal of Orthopaedic Surgery and Research, Vol 16, Iss 1, Pp 1-14 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Fibular grafting Humeral head reconstruction Locked gleno-humeral dislocation Posterior gleno-humeral dislocation Reverse Hill-Sachs defect Orthopedic surgery RD701-811 Diseases of the musculoskeletal system RC925-935
spellingShingle	Fibular grafting Humeral head reconstruction Locked gleno-humeral dislocation Posterior gleno-humeral dislocation Reverse Hill-Sachs defect Orthopedic surgery RD701-811 Diseases of the musculoskeletal system RC925-935 Amr Abdel-Mordy Kandeel Chronic locked posterior gleno-humeral dislocation: technical note on fibular grafting for restoration of humeral head sphericity
description	Abstract Background Reconstruction of reverse Hill-Sachs defect using osteo-chondral allograft has the advantages of spherical re-contouring and provision of smooth biological articular surface of the reconstructed humeral head. However, worldwide availability and risk of disease transmission of osteo-chondral allograft remain points of increasing concerns. As an alternative to lacking osteo-chondral allograft, the current technical note describes a reconstructive technique of reverse Hill-Sachs defect using autologous fibular grafting. Methods Following open reduction of the dislocated humeral head, reverse Hill-Sachs defect was reconstructed using 3–4 autologous fibular pieces (each is of 10 mm in length) fixed in flush with the articular cartilage using 4-mm cancellous screws. Defect reconstruction was then followed by modified McLaughlin’s transfer and posterior capsulorrhaphy. Results Spherical contour of the humeral head and gleno-humeral range of motion were restored. Intra-operative dynamic testing of the reconstruct revealed no residual posterior gleno-humeral instability. Conclusion Currently reported technique might offer advantages of graft availability, technical simplicity, familiarity and reproducibility, safety (i.e. no disease transmission) and bone preservation facilitating future revision management (if needed). Nevertheless, long-term outcomes of this technique should be investigated via further cohort clinical studies.
format	article
author	Amr Abdel-Mordy Kandeel
author_facet	Amr Abdel-Mordy Kandeel
author_sort	Amr Abdel-Mordy Kandeel
title	Chronic locked posterior gleno-humeral dislocation: technical note on fibular grafting for restoration of humeral head sphericity
title_short	Chronic locked posterior gleno-humeral dislocation: technical note on fibular grafting for restoration of humeral head sphericity
title_full	Chronic locked posterior gleno-humeral dislocation: technical note on fibular grafting for restoration of humeral head sphericity
title_fullStr	Chronic locked posterior gleno-humeral dislocation: technical note on fibular grafting for restoration of humeral head sphericity
title_full_unstemmed	Chronic locked posterior gleno-humeral dislocation: technical note on fibular grafting for restoration of humeral head sphericity
title_sort	chronic locked posterior gleno-humeral dislocation: technical note on fibular grafting for restoration of humeral head sphericity
publisher	BMC
publishDate	2021
url	https://doaj.org/article/39e4b1708c3e4ebbadcdefcd63a376cb
work_keys_str_mv	AT amrabdelmordykandeel chroniclockedposteriorglenohumeraldislocationtechnicalnoteonfibulargraftingforrestorationofhumeralheadsphericity
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Chronic locked posterior gleno-humeral dislocation: technical note on fibular grafting for restoration of humeral head sphericity

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