The ‘Floating Humeral Head’, A Case Series of Combined Proximal Humeral and Glenoid Fracture Dislocations

Abstract

Background: Fracture of the proximal humerus combined with dislocation of the glenohumeral joint and a soft tissue or bony Bankart lesion are rare. Management options are largely surgical and different approaches to fixation have been described. The reported outcomes are generally poor. Methods: We present a series of three rare cases of traumatic dislocations of the shoulder associated with combined fractures of the proximal humerus and glenoid that were treated with surgical fixation. We describe the surgical technique and clinical outcomes. Results: Our patients had multiple medical comorbidities; and coupled with the burden of injury, made a slow post-operative recovery (mean Constant-Murley score of 48 points over a mean follow-up time of 20 months). Conclusion: A high index of suspicion and appropriate imaging is required to properly diagnose and surgically manage this uncommon pattern of injury. We recommend surgical treatment of these severe injuries, to stabilise the glenohumeral joint, and to achieve optimal clinical outcomes.

A Unique Presentation of the Glenoid, Coracoid, and Proximal Humerus Fractures

“…Proximal humerus fractures and glenoid concomitant fractures are rare injuries that are usually caused by high-energy trauma and present with significant shoulder instability [ 1 ]. Another rare traumatic presentation of the shoulder girdle is that of a proximal humerus greater tuberosity and coracoid process fracture [ 2 ], and this has been described as happening in the context of an anterior shoulder dislocation.…”