Case Report: Revision surgery for a missed posterior dislocation of the humeral head in a shoulder fracture-dislocation and literature review - Report - MDSpire

Case Report: Revision surgery for a missed posterior dislocation of the humeral head in a shoulder fracture-dislocation and literature review

  • By

  • Xin Hu

  • Gang Zheng

  • Wei Zhao

  • Hao Dong

  • Jinhao Li

  • Zhe Hu

  • Haoming Lu

  • Dewei Shen

  • Nan Wang

  • April 30, 2026

  • 0 min

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Clinical Report: Revision Surgery for Undetected Posterior Humeral Head Dislocation

Overview

This report discusses a case of missed posterior shoulder dislocation associated with a proximal humeral fracture, highlighting the importance of thorough imaging. Revision surgery led to a favorable long-term outcome, emphasizing the need for improved diagnostic protocols.

Background

Posterior shoulder dislocation (PSD) is a rare injury that can be easily overlooked, particularly when accompanied by complex proximal humeral fractures. The missed diagnosis rate can be as high as 60%, leading to inappropriate management and potential long-term complications. Standardized imaging protocols are essential for accurate diagnosis and treatment.

Data Highlights

No numerical data available.

Key Findings

  • Posterior shoulder dislocation accounts for 1.1%–4.7% of all shoulder dislocations.
  • Missed diagnosis rates can reach 60% due to nonspecific clinical presentation and inadequate imaging.
  • Complex fracture lines can obscure radiographic signs of dislocation, complicating diagnosis.
  • Revision surgery can lead to satisfactory long-term outcomes even after initial treatment failure.
  • Timely imaging, including axillary or scapular Y-view radiographs, is critical for diagnosis.

Clinical Implications

Healthcare professionals should maintain a high index of suspicion for posterior shoulder dislocation in patients with complex proximal humeral fractures. Implementing standardized imaging protocols can significantly reduce the risk of missed diagnoses and improve patient outcomes.

Conclusion

This case underscores the importance of thorough imaging in diagnosing posterior shoulder dislocations. Early recognition and appropriate surgical intervention can lead to favorable long-term outcomes.

References

  1. Long-term clinical outcomes of joint-preserving surgery for posterior shoulder dislocation with a reverse Hill–Sachs lesion: A 10-year follow-up study, 2022
  2. Non-displaced to minimally displaced intraoperative periprosthetic humeral shaft fractures during reverse total shoulder arthroplasty do not impact short-term clinical and radiographic outcomes, 2021
  3. Approaches to Managing Displaced Surgical Neck Fractures of the Humerus: The Ineffectiveness of Hanging for Fracture Realignment, 2022
  4. A Retrospective Audit of the Management of Shoulder Dislocations at a Trauma Unit - PMC, 2023
  5. The duration of dislocation is the most important prognostic factor in chronic locked posterior shoulder dislocations treated with the modified McLaughlin surgical procedure: a multicentre study | BMC Musculoskeletal Disorders | Springer Nature Link, 2025
  6. Trans-fracture Technique for Open Reduction and Internal Fixation of Distal Humerus Coronal Shear Fractures
  7. A Retrospective Audit of the Management of Shoulder Dislocations at a Trauma Unit - PMC
  8. The duration of dislocation is the most important prognostic factor in chronic locked posterior shoulder dislocations treated with the modified McLaughlin surgical procedure: a multicentre study | BMC Musculoskeletal Disorders | Springer Nature Link

Original Source(s)

Case Report: Revision surgery for a missed posterior dislocation of the humeral head in a shoulder fracture-dislocation and literature review

  • by Xin Hu, Gang Zheng, Wei Zhao, Hao Dong, Jinhao Li, Zhe Hu, Haoming Lu, Dewei Shen, Nan Wang

  • April 30, 2026

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