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Missed Posterior Fracture-Dislocation of the Humeral Head. A Case Report with a Fifteen-Year Follow-up After Delayed Open Reduction and Internal Fixation*
T. KENNETH KAAR, M.D.†; MICHAEL A. WIRTH, M.D.†; CHARLES A. ROCKWOOD, JR., M.D.†, SAN ANTONIO, TEXAS
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Investigation performed at the Shoulder Service, Department of Orthopaedics, University of Texas Medical School and Health Science Center, San Antonio
J Bone Joint Surg Am, 1999 May 01;81(5):708-10
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Posterior fracture-dislocation of the humeral head is an uncommon and frequently missed injury of the shoulder. A delay in diagnosis may increase the risk of osteonecrosis and subsequent collapse of the humeral head. Some authors have advocated routine primary replacement of the humeral head with a prosthesis for these injuries, particularly if there has been a delay in treatment4. We describe the case of a patient who had a late diagnosis of a two-part fracture-dislocation of the anatomical neck of the humerus. The fracture was treated with open reduction and internal fixation, and the patient had no evidence of segmental collapse of the humeral head at the time of the fifteen-year follow-up.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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