A case of ipsilateral shoulder and elbow dislocation: an easily missed injury.

Abstract

An obese 33 year old woman presented to the accident and emergency (A&E) department following a fall down a flight of stairs. She complained of excruciating left elbow pain. There was an obvious deformity and an x ray confirmed a posterior dislocation of the elbow with a displaced fracture of the radial head (fig 1, left panel).The patient was referred to orthopaedics and booked for theatre. The casualty officer had attributed the patient's symptoms to the elbow injury and as a result did not remove her clothing. When the patient was seen on the way to theatre by the registrar her shirt was removed. This showed asymmetry between the two shoulder regions. Although the patient did not have any significant shoulder pain, an x ray was requested. This confirmed an anterior dislocation of the left shoulder (fig 1, right panel). Both were then reduced under general anaesthesia.

Ipsilateral fracture dislocation of the shoulder and elbow: A case report and literature review

“…Three of the nine previously reported cases initially missed the shoulder dislocation. 1,2,6 In all three, the patients presented with more pain, swelling and deformity at the elbow than at the shoulder. This probably overshadowed the less symptomatic shoulder dislocation and contributed to the delay in diagnosis.…”

“…Three authors did not describe the order of joint reduction. 2,8,9 We elected to reduce the elbow first. Once the elbow was stabilized with a spanning external fixator, our patient's posterior shoulder reduction was reduced, with gentle longitudinal traction and external rotation.…”

IPSILATERAL SIMULTANEOUS SHOULDER AND ELBOW DISLOCATION a case report

“…[4][5][6] Suman first reported a case of ipsilateral dislocation of the shoulder and elbow in 1981 in which a 31-year-old man involved in a road traffic accident while the influence of alcohol and suffered an injury. [4] The shoulder dislocation can be initially missed on admission owing to the marked swelling and severe pain located at the elbow.…”

“…The rarity of this injury may cause the diagnosis to be delayed or missed. [4][5][6] The aim of this study was to report such a case, to discuss its diagnostic pitfalls, mechanism, management and possible complications, ways to avoid a missed or delayed diagnosis and to review the literature.…”

Ipsilateral Shoulder and Elbow Dislocation: A Case Report

“…The elbow is the second most commonly dislocated joint after the shoulder. Ipsilateral shoulder and elbow dislocation is a very rare injury and only a few cases have been reported in the literature [1][2][3][4][5] . In most reported cases, shoulder joint dislocation was missed and diagnosed later.…”