Intrathoracic dislocation of the humeral head accompanied by polytrauma: How to treat it ?

Abstract

High-energy trauma to the shoulder is associated with multiple injuries and is often difficult to evaluate. One of these complex traumas is the displacement of the humeral head into the thoracic cavity. This study aimed to report a patient who presented after falling three floors. Initially, the patient underwent chest drainage and thoracoscopy to remove the displaced humeral head and, subsequently, underwent delayed artificial humeral head replacement. Hemodynamic stability, systematic evaluation, removal of the humeral head, and individual shoulder reconstruction are recommended for these patients.

Intrathoracic fracture—Dislocation of the shoulder

“…Enumerating the mechanism of injury, we can review 16 falls from height (same mechanism of our case), 2,[4][5][6][7][8][9][10][11][13][14][15][16][17][18][19] one fall of a bicycle, 12 five motor vehicle accidents, [20][21][22][23][24] and two were knocked down by a motor vehicle. 25,26 Two exceptions can be made regarding the mechanism of high energy: the cases published by Griffin et al and Salhiyyah et al in which the injury was a fall from standing height.…”

“…In the articles reviewed, eighteen authors opted for a shoulder arthroplasty and one of them used a reversed prosthesis. [7][8][9][10][11]14,15,[17][18][19][20][21][22]24,26,28 The reverse shoulder was used due to the high-energy comminution, stripping of the remaining tuberosity fragments, and extensive proximal bone loss. 14 There are four cases in the literature where the open reduction and internal fixation were chosen, including the instance of a two fragments fracture dislocation.…”

Dyspnea in a case of shoulder dislocation – to beware of this rare life-threatening symptom

“…In the absence of intra-thoracic complications, the removal of humeral head may not be necessary [ 2 ]. There is no uniform guideline for the treatment of this injury and each case must be appropriately managed according to its specific features [ 3 ]. A post reduction X-ray of a shoulder dislocation ensuring correct placement of humeral head in glenoid cavity will help in avoiding such complications.…”

Intrathoracic Fracture-dislocation of the Humeral Head:A Case Report and Review of the Literature

“…Intrathoracic fracture-humeral head dislocation has been rarely reported and requires a combination of high-energy trauma and speci c mechanisms. Enumerating the mechanism of injury, most of which are high-energy injuries.We can review including 18 falls from heigh [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18], 7 motor vehicle accidents [19][20][21][22][23][24][25], and 2 were knocked down by motor vehicles [26,27], 2 cases of falling from standing height [28,29], and 1 case of falling from a bicycle [30].…”