Akinosho Kitan, Weber William
Beth Israel Deaconess Medical Center, Department of Emergency Medicine, Boston, Massachusetts.
Rush University Medical Center, Department of Emergency Medicine, Chicago, Illinois.
Clin Pract Cases Emerg Med. 2024 Aug;8(3):302-304. doi: 10.5811/cpcem.7200.
We report a case of an 89-year-old female who presented with pain in her right shoulder following a fall onto her outstretched hand. Upon presentation, her right hand was held behind her head and elbow held above her head in flexion. There was obvious deformity seen and felt in her axilla. Radiograph of the shoulder showed an inferior shoulder dislocation and impacted humeral neck fracture. Given her age and comorbid osteoporosis, a bedside reduction was performed by orthopedics where the humeral head was intentionally dislocated from the humeral shaft. Thirteen days after the initial shoulder dislocation, the patient's shoulder was successfully repaired by open reduction.
Luxatio erecta, which means "erect dislocation" in Latin, refers to an inferior shoulder dislocation. It accounts for less than 1% of shoulder dislocations. Our case report highlights an inferior shoulder dislocation with a rare, concomitant humeral neck fracture, managed via staged reduction by orthopedics with intentional dislocation of the humeral head given concern over patient's age and osteoporosis. The patient was eventually successfully repaired via arthroplasty within two weeks.
我们报告一例89岁女性患者，她在伸手撑地摔倒后出现右肩部疼痛。就诊时，她的右手放在头后，肘部屈曲举过头顶。腋窝处可见并可摸到明显畸形。肩部X线片显示为下肩关节脱位合并肱骨颈嵌插骨折。考虑到她的年龄和合并的骨质疏松症，骨科医生在床边进行了复位，将肱骨头有意地从肱骨干脱位。初次肩关节脱位13天后，患者的肩部通过切开复位成功修复。
直立性脱位，在拉丁语中意为“直立脱位”，指的是下肩关节脱位。它占肩关节脱位的比例不到1%。我们的病例报告强调了一例罕见的下肩关节脱位合并肱骨颈骨折，鉴于患者年龄和骨质疏松症，由骨科医生分阶段进行复位，包括将肱骨头有意脱位。患者最终在两周内通过关节置换术成功修复。
