Demirel Mehmet, Anarat Berkan, Ersin Mehmet, Erşen Ali, Şen Cengiz
Istanbul Faculty of Medicine, Department of Orthopaedics and Traumatology, Istanbul University, Istanbul, Turkey.
Case Rep Orthop. 2016;2016:6910945. doi: 10.1155/2016/6910945. Epub 2016 Dec 19.
Inferior dislocation of the glenohumeral joint, known as luxatio erecta humeri, and posterior hip dislocation are both rare presentations in the emergency department. The most common aetiology is falling for luxatio erecta humeri. The aim of this manuscript was to present a unique case in terms of luxatio erecta humeri, which has a different aetiology, treatment method, and concomitant injury. We report a construction worker who was rescued from a collapsed building who presented with both luxatio erecta humeri and complex posterior hip dislocation. An orthopaedic surgeon reducted luxatio erecta humeri with a one-step reduction technique under procedural anaesthesia as soon as the patient's vital signs were stable. Different concomitant injuries and various injury mechanisms have been described in regard to inferior shoulder dislocation in the literature. However, posterior dislocation of the hip as a concomitant distant region injury and trapping as an injury mechanism for luxatio erecta humeri are being described for the first time in this case report. Two reduction manoeuvers, one-step and two-step, have been used for this dislocation. Some authors suggested that a two-step manoeuver can be more easy to apply. In our specific case, luxatio erecta was easily reducted by a single operator in a single attempt. Luxatio erecta humeri may occur from trapping and complex injuries can accompany luxatio erecta humeri in patients with multiple trauma. A one-step closed reduction can be easily applied by a single operator under procedural anaesthesia.
肩关节盂肱关节下脱位,即所谓的肩关节直举脱位,以及髋关节后脱位在急诊科均为罕见病例。肩关节直举脱位最常见的病因是跌倒。本文的目的是介绍一例肩关节直举脱位的独特病例,其病因、治疗方法及合并损伤均有所不同。我们报告一名从倒塌建筑物中获救的建筑工人,他同时存在肩关节直举脱位和复杂的髋关节后脱位。患者生命体征稳定后,一名骨科医生在程序麻醉下采用一步复位技术对肩关节直举脱位进行了复位。关于肩关节下脱位,文献中描述了不同的合并损伤和多种损伤机制。然而,本病例报告首次描述了髋关节后脱位作为合并的远处区域损伤以及被困作为肩关节直举脱位的损伤机制。对于这种脱位,已经使用了一步和两步两种复位手法。一些作者认为两步手法可能更容易应用。在我们的具体病例中,一名操作者单次尝试就轻松完成了肩关节直举脱位的复位。肩关节直举脱位可能因被困而发生,多发伤患者的肩关节直举脱位可能伴有复杂损伤。在程序麻醉下,一名操作者可以轻松应用一步闭合复位法。