Neglected anterior shoulder dislocation + Hill-sachs lesion: when masterly inactivity fails, what’s next?

Abstract

Background: Anterior shoulder dislocation is a
disabling injury affecting all age groups. Although
rarely missed, neglected shoulder dislocation may
occur in unconscious patients or due to inadequate
treatment as is common in low income countries.
Methodology: We report the management of a 26
year old man who presented with a five month
history of neglected anterior shoulder dislocation,
with gross limitation on all range of motion of the
affected shoulder. X-rays done (antero-posterior and
lateral views of the shoulder) also revealed a
malunited greater tuberosity fracture; for which the
patient had an open reduction and a Bristow-Laterjet
procedure.

Results: There was marked improvement in
symptoms and in the range of motion. There was
also no episode of re-dislocation within the follow up
period of two years.

Conclusion: Open reduction and the Bristow Laterjet
procedure is an effective way of managing the
neglected shoulder dislocation.