“Champagne Fracture”: A Superior Fracture-Dislocation of the Proximal Humerus

Abstract

A 79-year-old right-handed woman presented with an indirect trauma to her left shoulder after a fall down the stairs. X-rays and computed tomography showed a four-part glenohumeral fracture-dislocation with a subcutaneous ectopic location of the humeral head in the retroclavicular space. A reverse total shoulder arthroplasty was performed using a deltopectoral approach with direct superior extraction of the humeral head. The result at 2 years was a subjective shoulder value of 80%, an absolute Constant score of 59, and a relative Constant score of 92/100. To the best of our knowledge, this is the first description in the literature of such a lesion of superior glenohumeral fracture-dislocation and its treatment. Shoulder dislocations are very common injuries in the general population, affecting 23.9 people per 100,000 inhabitants per year in the United States 1 . Shoulder fracture-dislocation are rarer lesion entities than simple dislocations 2 . In regard to the direction of dislocation, anterior dislocations are the most common (72% of cases), followed by posterior dislocation 3 . Some uncommon dislocations were also published, with erect dislocations being a classic example. They represent inferior dislocations of the humeral head, typically resulting from injuries in a hyperabducted position 4 . Rare cases of intrathoracic 5 , superior 6 , or even retroperitoneal 7 dislocations have been reported.A patient was treated for a four-part glenohumeral fracturedislocation with a subcutaneous ectopic location of the humeral head in the retroclavicular space. After a collegial decision by the traumatological team, a reverse total shoulder arthroplasty was performed. The objective of this case report was to present the clinical and radiographic outcomes of the case at 2 years after the procedure.The medical information was anonymized, and the patient's consent for the use of this data was obtained.