Luxatio erecta bilateral: um relato de caso

Abstract

The authors declare that there was no conflict of interest in conducting this work ABSTRACTInferior shoulder dislocation (luxactio erecta) is a rare lesion affecting approximately 0.5% of dislocations of this joint. The vast majority of these cases occur unilaterally. In September 2004, a 43 year old man was brought to the emergency room of the University Hospital of Santa Maria (HUSM) complaining of bilateral shoulder pain and inability to lower the arms, as a result of a fall with the arms abducted, while carrying out work activities. After physical examination and radiological exams, it was found that the patient had a bilateral inferior shoulder dislocation.He was referred to the surgical ward and after intravenous sedation, both shoulders were reduced by closed reduction using the traction-countertraction maneuver. The patient was discharged the day after the reduction. Both arms were immobilized with a velpeau sling in total adduction and intrarotation, with instructions to maintain immobilization for three weeks. The patient was also advised to receive physiotherapy.

Bilateral Luxatio Erecta: An Atypical Presentation at the Emergency Department

“…The most common mechanism of injury, as observed in this case, comprises an indirect force of hyperabduction with a buttress effect of the humeral neck against the acromion, leading to a lever effect on the humeral head and consequent inferior dislocation [3][4][5]. Another mechanism is a direct trauma with axial load and inferior direction over the affected limb with an abducted arm and elbow in extension [1,6]. Conventional radiography with anteroposterior and axillary lateral views allows establishment of the diagnosis and exclusion of possible fractures, with computed tomography scan being reserved for further characterization.…”

“…The glenohumeral joint has the greatest range of motion amongst all joints in the body and, consequently, has the higher incidence of dislocations when compared to any other joint [1]. First described by Middledorpf and Scharm in 1859, lower dislocation accounts for approximately 0.5% of all cases of shoulder dislocation [7,8].…”

“…Conventional radiography with anteroposterior and axillary lateral views allows establishment of the diagnosis and exclusion of possible fractures, with computed tomography scan being reserved for further characterization. Among the various complications observed, fractures and rotator cuff tears remains the most frequent in 80% of cases, the last being best evaluated through magnetic resonance imaging [1,2]. In this case, the presence of traumatic pathology of the rotator cuff with partial tear and an undefined period of time, allowed the implementation of an effective rehabilitation protocol, resulting in gradual improvement of mobility and satisfactory functional outcomes.…”

“…Luxatio erecta or inferior glenohumeral dislocation is a rare lesion, representing around 0.5% of shoulder dislocation [1][2][3]. This usually appears after the trauma of the upper limb by a mechanism of forced hyperabduction, with a typical clinical presentation consisting of abduction of the arm, flexion of the elbow, and pronation of the forearm [4,5].…”

“…This usually appears after the trauma of the upper limb by a mechanism of forced hyperabduction, with a typical clinical presentation consisting of abduction of the arm, flexion of the elbow, and pronation of the forearm [4,5]. Complications described as fractures and rotator cuff tears can occur in 80% of the patients, followed by neurological injury in 60% of them, highlighting the importance of early diagnosis and treatment [1,6].…”