TRANSPOSITION OF SUBSCAPULARIS TENDON FOR THE TREATMENT OF A NEGLECTED POSTERIOR DISLOCATION OF THE SHOULDER - A CASE REPORT.

The shoulder joint can be considered one of the most important joints in the human body in regards to maintaining a good autonomy, due to its anatomical particularities that confer a wide range of motion. Scapulo-humeral dislocations limit the functionality of the joint and lead to an important decline in autonomy. Amongst shoulder dislocations, the posterior ones are considered rare and often lead to difficulties in diagnosis. Neglecting such lesions often leads to complications which can have a great impact on the treatment. We present a case which underlines these aspects, having particularities such as the young age of the patient (18 years old) and the rather long time of 4 months in which the lesion was neglected. Patient F. C. was admitted into our hospital with pain and functional impotence in his right shoulder, which appeared after a traumatic event 4 months ago. The clinical examination reveals limitation in range of motion for all the possible motions in the shoulder joint. Imaging studies (2 plain radiographs and a CT scan) reveal a posterior scapulo- humeral dislocation with a wedge type defect on the anterior aspect of the humeral head. Surgical treatment, chosen after a careful pre-operative planning, consisted of open reduction on a deltopectoral approach and the transposition of the subscapularis tendon into the humeral head. The patient underwent a specific postoperative rehabilitation program and was able to regain almost full range of motion in the shoulder joint. The importance of this case consists in underlining the possible complications of neglected shoulder dislocations, in the importance of pre-operative planning, which in this case dictated the surgical approach and method of stabilization, as well as the importance of a good understanding of the functional anatomy of the shoulder joint. [ABSTRACT FROM AUTHOR]