Anatomical osteocartilaginous reconstruction of MacLaughlin lesion in chronic locked posterior shoulder dislocation: A novel technique.

Background: Chronic Posterior shoulder dislocation presents significant challenges, with treatment decisions influenced by the duration of the injury and the severity of humeral head damage. This report highlights an innovative technique for reconstructing humeral head defects using an osteocartilaginous graft from costal cartilage, offering insights into the surgical procedure and the patient's favorable recovery outcomes.

Methods: The patient, a 23-year-old male with no significant medical history, was treated for a neglected posterior shoulder dislocation of two months' duration, complicated by a reverse Hill-Sachs lesion. The treatment involved an open reduction and reconstruction of the reverse Hill-Sachs lesion using costal cartilage. At the six-month follow-up, the patient was evaluated and demonstrated excellent shoulder function, with a Constant score of 92.5.

Conclusions: This technique introduces costal cartilage grafting for reverse Hill-Sachs lesion reconstruction, offering a novel anatomical approach to restore humeral head integrity. Unlike traditional methods, it ensures excellent biocompatibility, joint congruence, and stability while preserving shoulder mobility. Costal cartilage is abundant, versatile, and widely used in reconstructive surgery, yet its application in posterior shoulder dislocation remains unexplored. This method avoids tendon transfer complications and hardware-related issues, providing a promising alternative with reduced long-term risks and improved functional outcomes. Conclusions: Our technique utilizing an osteocartilaginous graft harvested from the costal cartilage, combined with meticulous soft tissue management, demonstrated a promising approach to reconstruct the humeral head and restore shoulder stability for chronic posterior shoulder dislocation with large reverse Hill-Sachs lesion.