Humeral Head Preservation after Neglected Glenohumeral Dislocation by Latarjet and Infraspinatus Remplissage—A Case Report

TL;DR

A 66-year-old man with a long-standing shoulder dislocation was successfully treated with a Latarjet procedure and infraspinatus tendon remplissage, preserving his natural shoulder joint.

Contribution

The paper presents a successful alternative to reverse shoulder arthroplasty by combining Latarjet and remplissage procedures to preserve the humeral head.

Findings

The patient had no complications and regained full function with no residual pain after 24 months.

The combination of Latarjet and remplissage procedures effectively stabilized the shoulder joint.

The patient's active range of motion was good at the 24-month follow-up.

Abstract

Background: Neglected anterior glenohumeral dislocations provide a challenging problem for physicians. For many patients with these injuries, reverse shoulder arthroplasty has been the treatment of choice, although the preservation of the patient’s own humeral head might have significant advantages. Methods: We present a case of a 66-year-old male with a neglected anterior glenohumeral dislocation that he sustained 6 weeks prior when he was hit by a car as a pedestrian. Radiographic imaging revealed a large off-track Hill-Sachs deformity and a fracture of the greater tuberosity in addition to the persisting glenohumeral dislocation. We performed open reduction and to aid stability, an infraspinatus tendon remplissage and a Latarjet procedure were performed. Results: Apart from minor and self-limiting neuropraxia, recovery was without complications. At 24 month follow-up, the patient had no impairment in general activities, had no residual pain, and had a good active range of motion. Conclusions: The authors, therefore, believe that a combination of infraspinatus tendon remplissage and the Latarjet procedure seems a feasible alternative for reverse shoulder arthroplasty and can preserve the patient’s own humeral head.

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