Intrathoracic Displacement of a Fractured Humeral Head due to Blunt Trauma

Tsai, Yi Yu; Shen, Pei; Chang, Hong‐Tai; Tzao, Ching; Lee, Shih Chun; Cheng, Yeung Leung

doi:10.5761/atcs.cr.12.02194

Cited by 7 publications

(7 citation statements)

References 5 publications

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“…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.…”

Section: Discussionmentioning

confidence: 99%

“…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.…”

Section: Discussionmentioning

confidence: 99%

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Intrathoracic fracture—Dislocation of the shoulder

Fernández

2018

Journal of Clinical Orthopaedics and Trauma

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Intrathoracic dislocation of the shoulder is a rare condition that usually occurs after high-energy trauma. Etiology, mechanism of injury and associated lesions are diverse. We present the case of a patient who suffered a great height fall, treated with removal of the humeral head and implantation of a shoulder hemiarthroplasty. One year after the surgery, the patient was pain free and the Constant score was 70 points.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Intrathoracic fracture—Dislocation of the shoulder

Fernández

2018

Journal of Clinical Orthopaedics and Trauma

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“…Fracture dislocation of proximal humerus with intrathoracic migration of the head is extremely rare [ 1 ]. In our case a violent unscientific maneuver probably caused levering of the humeral head over the 2nd to 5th ribs causing rib fractures as well as the intrathoracic migration of the humeral head.…”

Section: Discussionmentioning

confidence: 99%

“…The humeral head replacement with a prosthesis remains an issue of debate among orthopedic surgeons. Excision arthroplasty at the shoulder joint can improve the range of motion but can impair the quality of life with decreased strength and pain at shoulder joint [ 1 ]. Hence we preferred to replace the humeral head, though greater tuberosity reconstruction was not possible in this case.…”

Section: Discussionmentioning

confidence: 99%

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

Joshi

Challawar

Agrawal

et al. 2016

SICOT-J

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Shoulder dislocation is a common injury in orthopedic practice. In an acute presentation, closed reduction of the shoulder joint leads to an uneventful recovery. However, in the developing world neglected shoulder dislocation and treatments from quacks are not uncommon. Improper treatment and neglect can rarely become life threatening. We present one such case, emphasizing the need to investigate the symptom of dyspnea in a patient with history of shoulder dislocation.

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“…This study investigates a case report of intrathoracic fracture-dislocation of the humeral head. The reviews included falls from height (n=18) (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18), motor vehicle accidents (n=7) (19)(20)(21)(22)(23)(24)(25), knockdown by motor vehicles (n=2) (26,27), falling from standing height (n=2) (28,29), and falling from a bicycle (n=1) (30).…”

Section: Introductionmentioning

confidence: 99%

Intrathoracic fracture-dislocation of the humeral head: A case report and review of the literature

2021

ircmj

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Background: Intrathoracic displacement of a humeral head fracture is extremely rare. Only slightly more than 30 cases have been reported in this regard. Since few cases have been reported, there is no consensus on how to treat this injury. The etiology, injury mechanism, related lesions, and treatment of the injury are diverse. Case presentation: A 73-year-old female presented with multiple fractures of the left ribs, bilateral lung contusions, extensive emphysema of the anterior and posterior chest wall, massive left hemopneumothorax, fracture-dislocation of the proximal humerus, and intrathoracic displacement of the humeral head. The patient was sent to the operating room for emergency thoracotomy surgery. The head of the humerus was confirmed to be completely removed from the thoracic cavity during the operation. After discussion with the orthopedic surgeon, the humeral head was discarded considering avascular necrosis; moreover, open reduction and internal fixation were not performed. The orthopedic surgery team performed reverse shoulder arthroplasty three weeks later. During follow-up, the patient’s shoulder was free from pain, and its range of movement included 110° flexion, 70° abduction, 35° external rotation, and 50° internal rotation. Conclusion: Intrathoracic displacement of the humeral head due to proximal humeral fracture is a very rare and serious trauma that requires multidisciplinary treatment. Considering the extremely high risk of humeral head necrosis, actively removing broken bone fragments of the humeral head in the early stage is recommended, and we advocate for shoulder arthroplasty for elderly patients. Detailed preoperative evaluations and individualized operation plans should be made to achieve the best effect.

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Intrathoracic Displacement of a Fractured Humeral Head due to Blunt Trauma

Cited by 7 publications

References 5 publications

Intrathoracic fracture—Dislocation of the shoulder

Intrathoracic fracture—Dislocation of the shoulder

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

Intrathoracic fracture-dislocation of the humeral head: A case report and review of the literature

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