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Posterior fracture dislocation technical tip

This document provides a technical tip for reducing posterior fracture dislocations of the shoulder using a deltopectoral approach. It describes inserting a Shanz pin into the humeral head to gain purchase and applying laterally directed and rotatory forces to disengage and reposition the humeral head into the glenoid cavity. This method allows for reduction using a standard deltopectoral approach while preserving the humeral head's blood supply, reducing the risk of avascular necrosis.

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ORIF Of Posterior Fracture Dislocation Of The Shoulder Made Easy! W. Saadat B. Morgan P. Monga Upper Limb Unit, Wrightington Hospital
Background • Retrieving the humeral head from the posteriorly dislocated position in patients with posterior fracture dislocation of the shoulder can be challenge to a trauma surgeon.
Implication Of The Injury. • High risk of avascular necrosis. • Limited access via Deltopectoral approach. • Posterior approach unsuitable as there is a risk to remaining blood supply.
Technical Tip Deltopectoral approach. A Shanz pin is inserted into the humeral head to achieve purchase in the humeral head. GlenoidLaterally directed force Humeral Head
Steps of reduction • This disengages the humeral head off the posterior margin of the glenoid
Steps of reduction • A rotatory force then repositions the humeral head into a congruous position • ORIF is then carried out in a standard fashion
This simple tip aids reduction using a standard approach while preserving the blood supply of the humeral head Comments and Questions?