Intrathoracic fracture—Dislocation of the shoulder

Fernández, Alberto Izquierdo; Fernández, Ángel G.

doi:10.1016/j.jcot.2018.04.001

Cited by 3 publications

(7 citation statements)

References 27 publications

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“…Therefore, there is no precise consensus on the appropriate actions and timing to achieve better treatment outcomes and reduce the risk of complications. Injuries of this nature are usually caused by high-energy trauma, such as motor vehicle accidents, falls from stairs, or falls from heights [2][3][4][5][6]. In these and similar cases, the impact not only fractures the proximal part of the humerus but also forces the humeral head through all the tissues and ribs into the chest cavity.…”

Section: Discussionmentioning

confidence: 99%

Intratorakalinis žastikaulio galvos išnirimas, esant politraumai: klinikinio atvejo aprašymas

Sasnauskas,

Vrublevski,

Masionis

et al. 2024

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Intrathoracic displacement of the humeral head is rarely documented due to high mortality of the trauma. As a result, there is no clear consensus about how such case should be approached. In this report we reviewed our successful case, and reviewed the literature. The patient arrived after car accident with a broken humerus and upon taking X-ray found to have the humeral head lodged in the chest cavity. After humeral head removal and arthroplasty, patient was discharged without complications. In literature several cases were found in which a patient usually suffers because of high energy trauma with arm typically in abducted position. In all cases treatment involves removing humeral fragment from chest and prosthetic arthroplasty of the glenohumeral joint. Although some authors suggest leaving humeral fragment in some cases while others suggest to always remove. Exact indications of such decision are unclear. Cases like this pose a high risk of neurological and circulatory complications, although no complications were observed in this case. Nevertheless, there have been too few similar cases described to establish a proper methodology.

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Section: Discussionmentioning

confidence: 99%

Intratorakalinis žastikaulio galvos išnirimas, esant politraumai: klinikinio atvejo aprašymas

Sasnauskas,

Vrublevski,

Masionis

et al. 2024

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“…Some scholars have suggested that it is necessary to remove fragments only when there are cardiopulmonary complications. The reason for removal of bone fragments from the humeral head is that there may be related complications, such as infection or foreign body reactions [18]. It has been reported that the retained humeral head was removed 6 weeks late, and was embedded in the pulmonary parenchyma with extensive adhesion, requiring extensive resection [35].…”

Section: Discussionmentioning

confidence: 99%

“…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].…”

Section: Introductionmentioning

confidence: 99%

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

Yang

Lan

et al. 2021

Preprint

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BackgroundIntrathoracic displacement of a humeral head fracture is extremely rare.Only slightly more than 30 cases have been reported. Because 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 presentationA 73-year-old woman 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, and open reduction and internal fixation were not performed.Three weeks later, the orthopedic surgery team performed reverse shoulder arthroplasty.During follow-up, the patient’s shoulder was free from pain, and its range of movement (ROM) included 110° flexion, 70° abduction, 35° external rotation and 50° internal rotation.ConclusionsIntrathoracic 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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“…Some scholars have suggested that it is necessary to remove fragments only when there are cardiopulmonary complications. The reason for the removal of bone fragments from the humeral head is that there may be related to complications, such as infection or foreign body reactions (18). It has been reported that the retained humeral head was removed six weeks later and was embedded in the pulmonary parenchyma with extensive adhesion requiring extensive resection (29).…”

Section: Discussionmentioning

confidence: 99%

“…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 fracture—Dislocation of the shoulder

Cited by 3 publications

References 27 publications

Intratorakalinis žastikaulio galvos išnirimas, esant politraumai: klinikinio atvejo aprašymas

Intratorakalinis žastikaulio galvos išnirimas, esant politraumai: klinikinio atvejo aprašymas

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

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

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