- Discussion:
- defect in anteromedial portion resulting from posterior shoulder dislocation;
- management of this injury is determined by both the size of impression defect & time locked posterior dislocation has been present;
- Non Operative Treatment:
- if < 20% of joint surface is involved, joint usually remains stable after reduction;
- impression defects or head spliting frxs may result when the humeral head is severely impacted against the glenoid rim;
- esp w/, posterior dislocations which go unrecognized;
- Operative Treatment:
- defects involving 20-50% of joint surface, subscapularis tendon can be transferred into the defect, which should fill defect;
- w/ a defect of > 45% or > 6 month dislocation, consider arthroplasty;
- w/ involvement of glenoid consider total shoulder arthroplasty