Übersehen! - Die verhakte hintere schulterluxation: Arthroskopischer transfer des M. subscapularis in den reversen Hill-Sachs-defekt

Locked posterior shoulder dislocations are still a challenging problem for the treating orthopaedic surgeon. It is an uncommon and often misdiagnosed injury and there is often delay between injury and final diagnosis due to lack of appropriate radiographic evaluation or misinterpretation of clinical symptoms. We report about the case of an elderly lady with a traumatic locked posterior shoulder dislocation which was misdiagnosed at initial presentation. We treated her with a closed reduction followed by an arthroscopic M. subscapularis transfer into the reversed Hill Sachs defect. The clinical hallmark of a locked posterior dislocation is loss of external rotation on physical examination. Forward flexion might be limited but in contrast to anterior inferior dislocations it might be greater than 90°. A complete radiographic series including an axillary lateral view is essential to make the right diagnosis.