PMC6441765_01
(a) Clinical picture of bilateral shoulder showing a squaring left shoulder with muscle atrophy. (b) X-ray antero-posterior view of the left shoulder showing anterior dislocation of glenohumeral joint. (c) CT scan showed a Hill-Sachs lesion on the humeral head (pointed by arrow).
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On physical examination we found deformity on the left shoulder, liked a squaring shoulder (Fig. 1A), and muscle atrophy. The antero-posterior X-ray imaging showed anterior dislocation of left glenohumeral joint (Fig. 1B) and Computed Tomography (CT) scan showed a Hill-Sachs lesion on the humeral head (Fig. 1C).
Massive fibrotic tissue around humeral head (pointed by arrow).
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We performed an open reduction surgery using anterior approach of shoulder and found massive fibrotic tissue around the joint (Fig. 2) and the Hill-Sachs lesion.
(a) Latarjet procedure: osteotomized coracoid process has been attached to antero-posterior part of the glenoid rim (pointed by arrow). (b) Post-operative X-ray antero-posterior view of the left shoulder showing a reduce glenohumeral joint with fixation of Kirschner wire and 2 screws, in accordance with Latarjet procedure.
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The final result showed that the glenohumeral joint has been reduced with wire fixation (Fig. 3A). Post-operative X-ray showed a reduced shoulder joint (Fig. 3B).
Three months post-operative X-ray antero-posterior view of the left shoulder showing loss of the humeral head contour.
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Three months after surgery, the ulnar neuropraxia was healed but we found there were an osteolysis of coracoid graft and also an avascular necrosis of the humerus head (Fig. 4).