A young man with seizures incompletely controlled with medications and a brain stimulator, presented with posterior instability of the left shoulder that recurred after multiple closed reductions. His Grashey view showed overlap of the humeral and glenoid articular surfaces.
His scapular Y view showed posterior displacement of the humeral head relative to the glenoid.
Because of his incompletely controlled seizures a hemiarthroplasty was selected instead of a soft tissue procedure or allograft.
The locked position of the humeral head behind the glenoid was seen after the subscapularis peel.
The defect in the anterior humeral head was seen after reduction of the dislocation.
An anteriorly eccentric humeral component with a diameter of curvature equal to his native head was fixed to a standard impaction grafted humeral stem.
The day after surgery, he was started on assisted elevation of the arm. There was no evidence of posterior instability.
Self-assisted range of flexion at 6 days post op.
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Here are some videos that are of shoulder interest
Shoulder arthritis - what you need to know (see this link).
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The ream and run procedure (see this link).
The total shoulder arthroplasty (see this link).
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The smooth and move procedure for irreparable rotator cuff tears (see this link).
Shoulder rehabilitation exercises (see this link).
