Post-Operative Alopecia of the Scalp: A Rare Complication Following Shoulder Surgery

The document reports a rare case of post-operative alopecia, specifically pressure alopecia, following shoulder surgery in a 46-year-old woman who underwent an open reduction and internal fixation for a proximal humeral fracture. The surgery lasted 3 hours and 25 minutes, and the patient experienced hair loss in two 2x2 cm areas over the parieto-occipital area of the scalp, which was noted during the second post-operative week. The alopecia was reversible, and the hair regrew within 3 months. The condition is thought to be caused by pressure-induced ischemia of hair follicles due to improper head positioning during lengthy surgeries, which can be exacerbated by hypotension. The paper emphasizes the importance of orthopaedic surgeons and anaesthetists being aware of this complication and taking preventive measures such as proper patient head positioning and using soft foams. Most cases of post-operative alopecia are reversible, but in rare cases of permanent hair loss, surgical procedures like scalp reconstruction and hair transplantation are treatment options.