Inferior glenohumeral dislocation (luxatio erecta humeri)

Abstract

A 67-year-old woman was seen in the emergency department because of severe pain and inability to move her left shoulder after falling on an abducted left arm. The fall was the result of a near-syncopal episode. On examination, the left arm was hyperabducted and elevated approximately 80 degrees from the horizontal plane. Furthermore, the patient was unable to move her left arm. Radiographs of the shoulder revealed an inferior dislocation of the glenohumeral joint. Closed reduction in the emergency department was successful. This rare but classic case of inferior glenohumeral dislocation (Iuxatio erecta humeri) serves to emphasize that a heightened awareness for this injury is necessary if it is to be recognized and treated appropriately. It is important to obtain orthopedic consultation or follow-up (or both) for this injury, because of the high incidence of accompanying tears of the rotator cuff. Neurovascular compromise is also commonly associated with this dislocation. The neurologic injuries are more common than the vascular injuries but tend to resolve after reduction.

Traumatic Bilateral Luxatio Erecta from a Sliding Injury Down a Ladder; A Rare Case Report and Literature Review

“…Mallon et al reported that about 80% of luxatio erecta have fractures of the greater tuberosity or rotator cuff tears [8]. It has beenreported that approximately 50% of inferior shoulder dislocations have injuries to the rotator cuff [15]. In our case, the orthogonal radiographs obtained in office demonstrated bilateral high-riding humeral heads indicative of large rotator cuff tears.…”

Luxatio erecta humeri: Report of a swimming injury with analysis of the mechanism of the injury and associated injuries in literature

“…In this study, we reviewed the mechanism of injuries of all cases (57 articles) and classified the injuries into seven parts: Falling accidents (25 articles),[ 3 8 9 10 12 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 54 ] accidents related to working (5 articles),[ 12 14 35 36 37 38 ] sport related injuries (9 articles),[ 2 19 36 39 40 41 42 43 44 45 ] traffic accidents (10 articles),[ 4 13 15 45 46 47 48 49 50 57 ] alcholism, epilepsy, syncope, seizure and sleeping related injuries (6 articles),[ 5 8 18 40 51 52 ] unusual age (infant) with unusual mechanism (1 article),[ 53 ] boat accident (1 article)[ 54 ] [ Table 1 ].…”

Atypical Subglenoid Inferior Glenohumeral Dislocation Clinically Mimicking Anterior Dislocation

“…Direct downward pressure on the top of acromion rotates the scapula in anteroposterior axis so that the glenoid faces inferiorly toward the head of humerus enabling the relocation (Figures 3 and 4). An awareness of associated potential axillary artery injury, brachial plexus complications and rotator cuff tears is important in this rare entity and should be carefully assessed [6]. Ultrasonography, MRI scan and nerve electrophysiological studies are recommended in the post-reduction period as the incidence of the concomitant rotator cuff tears is high in true inferior dislocations especially when occurring in the age > 40 years.…”

“…Associated fracture can be inferior glenoid rim, greater tuberosity, coracoid process or acromion. The overall incidence of unilateral inferior dislocation is approximately one in 200 with 3.3% vascular injury, 60% neurologic injury and 80% rotator cuff injury rate [6,7]. In this case, the patient only had paresthesia in the distribution of the superficial cutaneous nerve of the forearm, which settled down spontaneously.…”