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Background <p>Chronic locked posterior shoulder dislocation (LPSD) mainly affects younger or middle-aged, functionally active patients—often as a&#xa0;result of seizures or electric shocks.</p> Therapy <p>The duration of dislocation and the size of the reverse Hill--Sachs lesion are decisive factors in the choice of treatment. Joint-preserving procedures are considered the treatment of choice for defects of less than 45–50% of the humeral articular surface and enable good functional results through anatomical reconstruction, preferably using a&#xa0;corticospongious autograft. Extra-anatomical procedures can be used for smaller defects, but are functionally limited.</p> Joint replacement <p>Joint replacement is indicated when reconstructive procedures are no longer possible due to large bone defects or additional soft tissue damage. In younger patients, it should be used with caution due to functional limitations and possible complications, while reverse shoulder arthroplasty is the last option for older patients or those with irreparable rotator cuffs.</p>

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Chronisch posterior verhakte Schulterluxation – Wann gelenkerhaltend, wann gelenkersetzend?

  • 期刊论文

  • 发表日期：

    2026年3月18日

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  • Caroline Jezoreck,
  • Ole Somberg,
  • Thomas A. Schildhauer,
  • Matthias Königshausen

摘要

Background

Chronic locked posterior shoulder dislocation (LPSD) mainly affects younger or middle-aged, functionally active patients—often as a result of seizures or electric shocks.

Therapy

The duration of dislocation and the size of the reverse Hill--Sachs lesion are decisive factors in the choice of treatment. Joint-preserving procedures are considered the treatment of choice for defects of less than 45–50% of the humeral articular surface and enable good functional results through anatomical reconstruction, preferably using a corticospongious autograft. Extra-anatomical procedures can be used for smaller defects, but are functionally limited.

Joint replacement

Joint replacement is indicated when reconstructive procedures are no longer possible due to large bone defects or additional soft tissue damage. In younger patients, it should be used with caution due to functional limitations and possible complications, while reverse shoulder arthroplasty is the last option for older patients or those with irreparable rotator cuffs.