The success of closed reduction in acute locked posterior fracture-dislocations of the shoulder

We retrospectively reviewed the results of closed treatment in 7 patients with acute locked posterior fracture-dislocations of the shoulder. Shoulders were reduced with patients under general anesthesia and were splinted in neutral rotation for 6 weeks. Follow-up averaged 46 months (range, 24-88 months). All shoulders were reduced within 14 days. Humeral head defects ranged from 18% to 32% of the articular surface, and all patients had documented posterior instability under anesthesia after relocation. Of the 7 patients, 6 had a stable shoulder. The mean American Shoulder and Elbow Surgeons shoulder index was 93.5 (range, 83-100). The mean findings with regard to motion were active forward elevation to 169°, external rotation to 73°, and internal rotation to T11. All patients without preexisting shoulder pathology were treated successfully. Closed management of acute posterior fracture-dislocations can be highly successful, even in the face of instability under anesthesia and a 30% humeral head defect.