Luxación posterior inveterada de hombro

Abstract

Introduction: Posterior dislocation of the shoulder is a pathology that is frequently underdiagnosed in the initial assessment1. It occurs between 2 to 5% of all dislocations and over 10% of shoulder instabilities2.
Clinical Case: A 35-year-old patient with left shoulder pain for 4 months, apparent cause of a bicycle falling, with an EVA (analog visual scale) of 8/10, accompanied by difficulty in limb mobility had received therapy analgesic and physiotherapy, without improvement of his clinical picture, so he decides to go to a specialist for evaluation. The physical examination shows left shoulder, painful to passive and active mobility, Flexion 40 °, extension 10 degrees, internal rotation at 90 °, External rotation blocked. In Rx AP signs of posterior shoulder dislocation:

1) Lost Moloney ?s line, 2) sign of the bulb, 3) vacant glenoid sign, 4) sign of the tire, 5 channel line. In transthoracic Rx, evident posterior dislocation of the shoulder. On CT, Moroder technique is performed to calculate the bone defect in the head of the humerus. In magnetic resonance imaging, periarticular fibrotic tissue is evident, with an image suggestive of posterior labrum lesion.

Discussion: Posterior shoulder dislocation is a pathology that occurs between 2 to 5% of all dislocations, there is a risk of not being diagnosed in a first medical visit between 60% to 79% of cases, as occurred in this case presented.