This document provides a technical tip for reducing posterior fracture dislocations of the shoulder using a deltopectoral approach. It describes inserting a Shanz pin into the humeral head to gain purchase and applying laterally directed and rotatory forces to disengage and reposition the humeral head into the glenoid cavity. This method allows for reduction using a standard deltopectoral approach while preserving the humeral head's blood supply, reducing the risk of avascular necrosis.

1. ORIF Of Posterior
Fracture Dislocation Of
The Shoulder Made Easy!
W. Saadat
B. Morgan
P. Monga
Upper Limb Unit, Wrightington Hospital

2. Background
• Retrieving the humeral head from the posteriorly dislocated
position in patients with posterior fracture dislocation of the
shoulder can be challenge to a trauma surgeon.

3. Implication Of The Injury.
• High risk of avascular necrosis.
• Limited access via Deltopectoral approach.
• Posterior approach unsuitable as there is a risk to remaining
blood supply.

4. Technical Tip
Deltopectoral approach.
A Shanz pin is inserted into the humeral head to achieve
purchase in the humeral head.
GlenoidLaterally directed force
Humeral Head

5. Steps of reduction
• This disengages the humeral head off the posterior margin of
the glenoid

6. Steps of reduction
• A rotatory force then repositions the humeral head into a
congruous position
• ORIF is then carried out in a standard fashion

7. This simple tip aids reduction using a standard approach while
preserving the blood supply of the humeral head
Comments and Questions?