Posterior Fracture Dislocation of the Shoulder: A Modified McLaughlin Procedure

Abstract

PURPOSE: Bilateral posterior fracture dislocation is a rare injury commonly associated with seizures. When the humeral head defect (reverse Hill-Sachs lesion) is between 20% and 45%, operative fixation using a modified McLaughlin procedure is recommended. This video demonstrates a case of bilateral posterior fracture dislocation after a drug-induced seizure treated with a modified McLaughlin procedure. METHODS: The original McLaughlin procedure involved transfer of the subscapularis tendon from the lesser tuberosity to the reverse Hill-Sachs defect. However, the modified McLaughlin procedure is more commonly described in the literature as of late and involved the transfer of the lesser tuberosity along with the subscapularis. RESULTS: This video demonstrates the modified McLaughlin technique for a posterior fracture dislocation. Computerized tomography confirms the articular impression fractures of the proximal humerus. Through a deltopectoral approach, the lesser tuberosity along with the subscapularis tendon was transferred into the defect. CONCLUSIONS: The modified McLaughlin procedure demonstrates excellent clinical and radiographic results after posterior fracture dislocation of the shoulder with a reverse Hill-Sachs lesion between 25% and 45%.