• TOORTHJ-12-7_F1

    Minimally Invasive Sacroiliac Joint Fusion: 2-Year Radiographic and Clinical Outcomes with a Principles-Based SIJ Fusion System

    Sacroiliac joint (SIJ) degeneration is a common source of low back pain (LBP). Minimally invasive (MI) SIJ fusion procedures have demonstrated meaningful clinical improvement. A recently developed MI SIJ fusion system incorporates decortication, placement of bone graft and fixation with threaded implants (DC/BG/TF).

  • TOORTHJ-12-1_F4

    Nonoperative Treatment of Midshaft Clavicle Fractures in Adults

    Clavicle fractures are among the most common skeletal injuries accounting for 2-5% of all adult fractures. Historically, nonoperative treatment of midshaft clavicular fractures was considered the gold standard of care.

  • TOORTHJ-11-934_F6

    Management of Glenoid Defects in Anterior Shoulder Instability

    Bone defects of the glenoid are often found in patients with traumatic anterior glenohumeral instability. There is no consensus regarding which glenoid defects need to be treated surgically. The aim of this review is to describe the management of glenoid defects in anterior shoulder instability in patients with traumatic anterior glenohumeral instability.

  • TOORTHJ-11-1066_F2

    Hallux Osteoid Osteoma: A Case Report and Literature Review

    Osteoid osteoma is a benign bone tumour that mostly affects males in the second and third decade of their life. The lesion mainly occurs in long bones, usually in the femur and tibia, causing severe localized pain that is worse at night and responds to nonsteroidal anti-inflammatory drugs (NSAIDs).

  • TOORTHJ-11-704_F5c

    Transplantation Treatment of Extensive Soft-Tissue Defects

    This article reported the ultilization of cross-bridge flap transplantation and combined free-tissue flap transplantation to treat a 54-year-old male with Gustilo type III-C injuries. Thorough debridement, external fixation and vacuum sealing drainage were performed in the fist-stage treatment.

  • TOORTHJ-11-1094_F2

    Cadaveric Anatomical Study of Sural Nerve

    To ascertain in cadavers where the sural nerve crosses the gastro-soleus complex and where the gastrocnemius tendon merges with the Achilles tendon in relation to the calcaneal tuberosities.

  • TOORTHJ-11-1142_F2

    A Case of Infrapatellar Fat Pad Ganglion of the Knee

    A 22-year-old female presented with a persistent medial knee joint pain in her left knee for 2 years. There was soft tissue swelling on the anteromedial aspect of the infrapatellar region on her left knee. Lachman and McMurray tests were negative. MRI showed a multilobular cyst in the infrapatellar fat pad with T1 low intensity and T2 STIR high intensity.

  • TOORTHJ-11-1154_F10

    Anatomic Outside-In Reconstruction of the Anterior Cruciate Ligament

    An anterior cruciate ligament (ACL) rupture is a frequent injury, with short and long-term consequences if left untreated. With a view to benefitting as many patients as possible and preventing future complications, we created a low-cost ligament reconstruction technique.

  • TOORTHJ-11-234_F3

    Cortical Fenestration for Megaprosthesis Stem Revision

    The most common modes of failure for megaprostheses are aseptic loosening followed by periprosthetic infection and stem fracture. Surgical technique for bone and implant exposure is controversial and may influence the success of revision and the need for additional future revisions.

  • TOORTHJ-11-327_F1

    Irreducible Anterior Shoulder Dislocation: A Case Report

    Failure of closed manipulative reduction of an acute anterior shoulder dislocation is seldom reported in the literature and is usually due to structural blocks such as soft tissue entrapment (biceps, subscapularis, labrum), bony fragments (glenoid, greater tuberosity) and severe head impaction (Hill-Sachs lesion).

Editor's Choice

Irreducible Anterior Shoulder Dislocation with Interposition of the Long Head of the Biceps and Greater Tuberosity Fracture: A Case Report and Review of the Literature

Konstantinos Pantazis, Andreas Panagopoulos, Irini Tatani, Basilis Daskalopoulos, Ilias Iliopoulos, Minos Tyllianakis


Failure of closed manipulative reduction of an acute anterior shoulder dislocation is seldom reported in the literature and is usually due to structural blocks such as soft tissue entrapment (biceps, subscapularis, labrum), bony fragments (glenoid, greater tuberosity) and severe head impaction (Hill-Sachs lesion).

Case report:

We present a case of an irreducible anterior shoulder dislocation in a 57-year-old male patient after a road-traffic accident. He had severe impaction of the head underneath glenoid rim and associated fracture of the greater tuberosity. Closed reduction performed in the emergency room under sedation and later at the theatre under general anaesthesia was unsuccessful. Open reduction using the dectopectoral approach revealed that the reason for obstruction was the posterolateral entrapment of the biceps tendon between the humeral head and the tuberosity fragment. Reduction was achieved after subscapularis tenotomy and opening of the joint; the tuberosity fragment was fixed with transosseous sutures and the long head of the biceps tendon was tenodesized. The patient had an uneventful postoperative recovery and at his last follow up, 12 months postoperatively, he had a stable joint, full range of motion and a Constant score of 90.


A comprehensive literature review revealed 22 similar reports affecting a total of 30 patients. Interposition of the LHBT alone or in combination with greater tuberosity fracture was the most common obstacle to reduction, followed by subscapularis tendon interposition and other less common reasons. Early surgical intervention with open reduction and confrontation of associated injuries is mandatory for a successful outcome.

April 27, 2017

Most Accessed Articles