Though Hill–Sachs lesion is a common injury associated with anterior glenohumeral dislocation, there have been only few articles describing specific treatments for the humeral head defects. This paper described the case of an alternative treatment for large defect of the posterior-superior aspect of the humeral head using allograft. The patient was a 69-year-old male and the diagnosis was a chronic anterior dislocation of the right glenohumeral joint with a large impaction fracture of the posterior-superior aspect of the humeral head. The size of this defect was 4 cm by 2.5 cm in diameter with a 2 cm depth. To reduce the impaction fracture of the humeral head, a preserved frozen allograft of the femoral head was selected and configured to fit the defect. The graft was then impacted firmly down into the defect, and appeared to offer excellent stability even without adjuvant internal fixation. Two years after surgery, the patient was doing quite well with no complaints. Radiographs showed humeral head with incorporation of the graft and no evidence of collapse.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Injury
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
Browner BD, Jupiter JB, Levine AM, et al. editors. Skeletal trauma: Fractures, dislocations, ligamentous injuries, Vol. 2. Philadelphia: W.B. Saunders Company, 1998. p. 1640.
- The incidence of Hill–Sachs lesions in initial anterior shoulder dislocations.Arthroscopy. 1989; 5: 254
- Humeral head defects associated with shoulder dislocations—their diagnostic and surgical significance.AAOS Instr Course Lect. 1972; 21: 42
- On the pathological changes produced in the shoulder-joint by traumatic dislocation, as derived from an examination of all specimens illustrating this injury in the museums of London.Trans Pathol Soc, London. 1861; 12: 179
- Osteoarticular allografts to treat distal femoral osteonecrosis.Clin Orthop. 1994; 303: 38
- Fresh osteochondral allografts for treatment of articular defects in osteochondritis dissecans of the lateral femoral condyle in adults.Clin Orthop. 1994; 303: 33
- Allograft reconstruction of segmental defects of the humeral head for the treatment of chronic locked posterior dislocation of the shoulder.J Bone Joint Surg. 1996; 78-A: 376
- Dislocations of the shoulder with special reference to accompanying small fracture.J Bone Joint Surg. 1959; 41 A: 489
- Locked posterior dislocation of the shoulder.J Bone Joint Surg. 1987; 69 A: 9
- The groove defect of the humeral head. A frequency unrecognized complication of dislocations of the shoulder joint.Radiology. 1940; 35: 690
- Anterior Dislocation of the shoulder in teenagers and young adults.J Bone Joint Surg. 1987; 69-A: 393
- Primary anterior dislocation of the shoulder in young patients.J Bone Joint Surg. 1996; 78: 1677
- Massive bone allograft for traumatic skeletal defects.South Med J. 1991; 84: 975
- Fresh small-fragment osteochondral allografts: long-term follow-up study on first 100 cases.Clin Orthop. 1985; 197: 96
- Resurfacing of the knee with fresh osteochondral allograft.J Bone Joint Surg. 1989; 71-A: 704
- Prosthetic replacement for chronic unreduced dislocations of the shoulder.Clin Orthop. 1687; 216: 89
- Combined auto- and alloosteochondral grafts for large defects.J Trauma. 1986; 26: 189
- Prognosis in anterior shoulder dislocation.Am J Sport Med. 1984; 12: 19
- Cadaveric elbow allografts: a 6-year experience.Clin Orthop. 1985; 197: 131
Accepted: February 7, 2002
© 2002 Elsevier Science Ltd. Published by Elsevier Inc. All rights reserved.