Inferior shoulder dislocation - Revision history

Blsimpso at 13:42, 29 June 2021

2021-06-29T13:42:56Z

← Older revision		Revision as of 13:42, 29 June 2021
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	==See Also==		==See Also==
	*[[Shoulder dislocation]]		*[[Shoulder dislocation]]

			==External Links==

			===Videos===
			{{#widget:YouTube\|id=k_ORI51luFI}}


	==References==		==References==

Rossdonaldson1: /* Clinical Features */

2020-06-22T20:19:53Z

Clinical Features

← Older revision		Revision as of 20:19, 22 June 2020
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	**Hand on or behind head		**Hand on or behind head
	*Humeral head palpable in axilla or lateral chest wall<ref name="Imerci">Imerci A, Gölcük Y, Uğur SG, et al. Inferior glenohumeral dislocation (luxatio erecta humeri): report of six cases and review of the literature. Ulus Travma Acil Cerrahi Derg. 2013 Jan;19(1):41-4.</ref>		*Humeral head palpable in axilla or lateral chest wall<ref name="Imerci">Imerci A, Gölcük Y, Uğur SG, et al. Inferior glenohumeral dislocation (luxatio erecta humeri): report of six cases and review of the literature. Ulus Travma Acil Cerrahi Derg. 2013 Jan;19(1):41-4.</ref>

	~~===Associated Injuries===~~
	*Inferior capsule and/or rotator cuff injury
	*Greater tuberosity fracture
	*Axillary artery and brachial plexus injury (typically resolve after reduction)

	==Differential Diagnosis==		==Differential Diagnosis==

Rossdonaldson1: /* Clinical Features */

2020-06-22T20:19:34Z

Clinical Features

← Older revision		Revision as of 20:19, 22 June 2020
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	**Hand on or behind head		**Hand on or behind head
	*Humeral head palpable in axilla or lateral chest wall<ref name="Imerci">Imerci A, Gölcük Y, Uğur SG, et al. Inferior glenohumeral dislocation (luxatio erecta humeri): report of six cases and review of the literature. Ulus Travma Acil Cerrahi Derg. 2013 Jan;19(1):41-4.</ref>		*Humeral head palpable in axilla or lateral chest wall<ref name="Imerci">Imerci A, Gölcük Y, Uğur SG, et al. Inferior glenohumeral dislocation (luxatio erecta humeri): report of six cases and review of the literature. Ulus Travma Acil Cerrahi Derg. 2013 Jan;19(1):41-4.</ref>

			===Associated Injuries===
			*Inferior capsule and/or rotator cuff injury
			*Greater tuberosity fracture
			*Axillary artery and brachial plexus injury (typically resolve after reduction)

	==Differential Diagnosis==		==Differential Diagnosis==

Rossdonaldson1: /* Clinical Features */

2020-06-22T20:13:10Z

Clinical Features

← Older revision		Revision as of 20:13, 22 June 2020
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	==Clinical Features==		==Clinical Features==
			*Mechanism: forceful hyper-abduction of arm
	*Humerus fully abducted		*Humerus fully abducted
	**Hand on or behind head		**Hand on or behind head

Rossdonaldson1 at 18:55, 16 June 2020

2020-06-16T18:55:40Z

← Older revision		Revision as of 18:55, 16 June 2020
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	*Suspected major vascular injury		*Suspected major vascular injury
	*In these cases, open reduction is indicated		*In these cases, open reduction is indicated

			==Disposition==
			*Discharge after successful reduction
			*Outpatient orthopedic surgery follow-up

	==Complications==		==Complications==
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	*[[Humerus fracture]] in 37%		*[[Humerus fracture]] in 37%
	*[[Rotator cuff tear]] in 12%		*[[Rotator cuff tear]] in 12%

	~~==Disposition==~~
	*Discharge after successful reduction
	*Outpatient orthopedic surgery follow-up

	==See Also==		==See Also==

Rossdonaldson1: /* Complications */

2020-06-16T18:53:44Z

Complications

← Older revision		Revision as of 18:53, 16 June 2020
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	==Complications==		==Complications==
	**Axillary nerve palsy in 60% (usually rapidly resolves after reduction<ref name="Grate" />		*[[Axillary nerve palsy]] in 60% (usually rapidly resolves after reduction<ref name="Grate" />
	**Humerus fracture in 37%		*[[Humerus fracture]] in 37%
	**Rotator cuff tear in 12%		*[[Rotator cuff tear]] in 12%

	==Disposition==		==Disposition==

Rossdonaldson1: /* Two-Step TechniqueDavenport M. Procedures for orthopedic emergencies. In: Bond M, ed. Orthopedic Emergencies: Expert Management for the Emergency Physician. Cambridge: Cambridge University Press; October 31, 2013. Horn A. Management of Common Dislo...

2020-06-16T18:53:17Z

/* Two-Step TechniqueDavenport M. Procedures for orthopedic emergencies. In: Bond M, ed. Orthopedic Emergencies: Expert Management for the Emergency Physician. Cambridge: Cambridge University Press; October 31, 2013. Horn A. Management of Common Dislo...

← Older revision		Revision as of 18:53, 16 June 2020
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	#Place second hand on medial epicondyle of elbow		#Place second hand on medial epicondyle of elbow
	#Use first hand to apply pressure to the mid-shaft of the humerus while the second hand pulls the elbow cephalad		#Use first hand to apply pressure to the mid-shaft of the humerus while the second hand pulls the elbow cephalad
	#Perform reduction of the [[anterior shoulder ~~dislocaiton~~]]		#Perform reduction of the [[anterior shoulder dislocation]]
	#Place arm in shoulder immobilizer		#Place arm in shoulder immobilizer
	#Obtain post-reduction radiographs		#Obtain post-reduction radiographs

Rossdonaldson1: /* Background */

2020-06-16T18:52:06Z

Background

← Older revision		Revision as of 18:52, 16 June 2020
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	==Background==		==Background==
			[[File:Gray326.png\|thumb\|Left shoulder and acromioclavicular joints with ligaments.]]
	[[File:Shoulder_joint_back-en.png\|thumb\|Shoulder anatomy, anterior.]]		[[File:Shoulder_joint_back-en.png\|thumb\|Shoulder anatomy, anterior.]]
	[[File:Shoulder joint back 05r4v.png\|thumb\|Shoulder anatomy, posterior.]]		[[File:Shoulder joint back 05r4v.png\|thumb\|Shoulder anatomy, posterior.]]

Rossdonaldson1: /* Background */

2020-06-16T18:34:09Z

Background

← Older revision		Revision as of 18:34, 16 June 2020
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	**Rarely caused by high-energy force applied to shoulder from above<ref name="Grate">Grate I Jr. Luxatio erecta: a rarely seen, but often missed shoulder dislocation. Am J Emerg Med. 2000 May;18(3):317-21.</ref>		**Rarely caused by high-energy force applied to shoulder from above<ref name="Grate">Grate I Jr. Luxatio erecta: a rarely seen, but often missed shoulder dislocation. Am J Emerg Med. 2000 May;18(3):317-21.</ref>
	*Frequently associated with significant soft tissue injury or fracture<ref name="Imerci" />		*Frequently associated with significant soft tissue injury or fracture<ref name="Imerci" />

			{{Shoulder dislocation types}}

	==Clinical Features==		==Clinical Features==

Rossdonaldson1 at 20:28, 21 May 2020

2020-05-21T20:28:16Z

← Older revision		Revision as of 20:28, 21 May 2020
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	[[File:Shoulder_joint_back-en.png\|thumb\|Shoulder anatomy, anterior.]]		[[File:Shoulder_joint_back-en.png\|thumb\|Shoulder anatomy, anterior.]]
	[[File:Shoulder joint back 05r4v.png\|thumb\|Shoulder anatomy, posterior.]]		[[File:Shoulder joint back 05r4v.png\|thumb\|Shoulder anatomy, posterior.]]
	~~[[File:Inferiourdislocation.jpg\|thumb\|Inferior dislocation with fracture of the greater tuberosity. Note how the humerus is abducted.]]~~
	*Also known as "Luxatio Erecta" due to the affected arm being held 'erect', in a fully-abducted position		*Also known as "Luxatio Erecta" due to the affected arm being held 'erect', in a fully-abducted position
	*About 0.5% of shoulder dislocations<ref name="Imerci" />		*About 0.5% of shoulder dislocations<ref name="Imerci" />
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	==Evaluation==		==Evaluation==
			[[File:Inferiourdislocation.jpg\|thumb\|Inferior dislocation with fracture of the greater tuberosity. Note how the humerus is abducted.]]
	*Plain film X-ray in at least 2 views		*Plain film X-ray in at least 2 views