Inferior glenohumeral dislocation (luxatio erecta humeri).
A 67-year-old woman was seen in the emergency department because of severe pain and inability to move her left shoulder after falling on an abducted left arm. The fall was the result of a near-syncopal episode. On examination, the left arm was hyperabducted and elevated approximately 80 degrees from the horizontal plane. Furthermore, the patient was unable to move her left arm. Radiographs of the shoulder revealed an inferior dislocation of the glenohumeral joint. Closed reduction in the emergency department was successful. This rare but classic case of inferior glenohumeral dislocation (luxatio erecta humeri) serves to emphasize that a heightened awareness for this injury is necessary if it is to be recognized and treated appropriately. It is important to obtain orthopedic consultation or follow-up (or both) for this injury, because of the high incidence of accompanying tears of the rotator cuff. Neurovascular compromise is also commonly associated with this dislocation. The neurologic injuries are more common than the vascular injuries but tend to resolve after reduction.
Padgham
M
M
Section of Emergency Medicine and Trauma, University of Oklahoma Health Sciences Center, Oklahoma City 73126-0307, USA.
Walker
J S
JS
D000058:Accidental Falls; D000359:Aftercare; D000368:Aged; D005260:Female; D006801:Humans; D008349:Manipulation, Orthopedic / Q000379:methods; D009985:Orthopedics; D011859:Radiography; D012017:Referral and Consultation; D012783:Shoulder Dislocation / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy