Bioabsorbable Screws and Tibial Crest Autograft for the Treatment of Posterior Shoulder Fracture-Dislocation: A Case Report

TL;DR

A new surgical method using bioabsorbable screws and a bone graft successfully treated a rare shoulder injury in a young patient.

Contribution

A novel surgical technique combining bioabsorbable screws and tibial crest autograft for posterior shoulder fracture-dislocation is presented.

Findings

The patient achieved full range of motion and graft integration within three months.

Bone healing was complete at six months without avascular necrosis.

The patient returned to full activity and remained asymptomatic at three years.

Abstract

Posterior shoulder fracture-dislocations represent a rare and commonly misdiagnosed injury, especially in young adults. Management is controversial, with internal fixation preferred over arthroplasty in cases where humeral head viability can be preserved. This report describes a novel approach using bioabsorbable screws and tibial crest autograft for anatomical reconstruction. A 34-year-old male presented with a posterior dislocation and anatomical neck fracture of the left humerus following a motorcycle accident. Closed reduction was unsuccessful. The patient underwent open reduction and internal fixation via a deltopectoral approach. The humeral head was temporarily explanted, a tibial crest autograft was harvested and inserted, and fixation was achieved using three bioabsorbable poly-L-lactic acid (PLLA) interference screws. The postoperative course was uneventful. At three months, a full range of motion was achieved with radiological evidence of graft integration. At six months, bone healing was complete without signs of avascular necrosis. The patient returned to full activity by nine months and remained asymptomatic at the three-year follow-up. This report supports the use of bioabsorbable screws and autologous grafting as a viable option for treating young patients with posterior shoulder fracture-dislocation. The technique offers anatomical restoration while preserving future surgical options.

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