Long-term follow-up of a posterior glenohumeral fracture-dislocation treated with open reduction and internal fixation: a case report

Posterior glenohumeral fracture dislocations are rare with a prevalence of 0.6/100,000 and represent only 0.9% of all shoulder fracture dislocations. They are caused most often by high-energy trauma, seizure, or electrocution. Diagnosis is often missed or delayed due to the infrequency of this injury. Delayed diagnosis increases the patient’s risk of developing long-term sequelae such as chronic posterior instability and avascular necrosis of the humeral head. Patients typically present with shoulder pain and the inability to rotate externally. Radiographs may demonstrate the light bulb sign on an anteroposterior view, and an axillary view can confirm a posterior dislocation. A CT scan usually is obtained in these patients to further confirm the diagnosis and provide better fracture characterization. There is no consensus on the best way to treat a posterior glenohumeral fracture-dislocation. Depending on the injury pattern and patient characteristics, options include open reduction and internal fixation (ORIF); modified McLaughlin procedure; hemi-, total, or reverse shoulder arthroplasty; and allograft or autograft reconstruction. This case report describes successful treatment with ORIF and 13-year follow-up of a posterior glenohumeral fracture dislocation with an anatomic neck fracture. The patient was informed that data concerning the case would be submitted for publication, and he provided consent.