Patients and methods

In the period from February 2001 to November 2009, 14 patients with obstetric palsy with posterior humeral head dislocation had a centering osteotomy procedure. Joint incongruence was diagnosed by clinical exam in which the humeral head was palpated at the posterior aspect of the shoulder, limited external rotation and by the presence of the Putti sign. The Putti sign is present when there is an elevation of the upper corner of the scapula when the shoulder is passively adducted and externally rotated with the elbow in 90" of flexion. In addition to the clinical exam, imaging tests (X-ray and CTs or MRI) were also performed.

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