Inferior Dislocation of Shoulder Complicated with Undisplaced Greater Tuberosity Fracture, Rupture of the Supraspinatus Tendon, and Brachial Plexus Injury in the Elderly: Case Report and Literature Review

Vasiliadis, Angelo V.; Kalitsis, Christos; Kantas, Theofanis; Biniaris, George

doi:10.1155/2020/9420184

Cited by 5 publications

(2 citation statements)

References 19 publications

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“…On clinical examination upon presentation, the average reported humeral abduction is 120° (80°-170°). 2, 4 Injuries to the inferior shoulder have been linked to two different mechanisms, which are direct and indirect. In the direct mechanism, the head of the humerus is forced upon the relatively less soft joint capsule and the inferior glenohumeral ligaments on a completely abducted arm.…”

Section: Discussionmentioning

confidence: 99%

Inferior shoulder dislocation with greater tuberosity avulsion fracture treated with Traction-Countertraction method in a rural hospital: A case report and literature review

Kusuman

Wiryadana

Rante

2022

Intisari Sains Medis

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Introduction. Inferior shoulder dislocation is considered a rare event. Although there is a seemingly low chance of occurrence, this condition should not be prematurely ruled out in the presence of acute shoulder pain. Case. A 45 years old woman complained of pain in her left shoulder and was unable to bring her arm lower than 90° after a car accident. The patient unintentionally put her left arm outstretched above her head to avoid head impact during the crash, causing hyperabduction of the shoulder. She experienced pain, numbness and could not move the ipsilateral hand. Her left arm was locked in hyperabduction (100°), and her elbow was extended. Close inspection showed a loss of left shoulder contour. On palpation, the humeral head was palpable in the axilla. Anteroposterior X-ray view confirmed inferior dislocation of the left shoulder with associated greater tuberosity fracture. A closed reduction under general anesthesia with the traction-counter traction technique was conducted as commonly used in rural settings. After perfect anatomical reduction was obtained and confirmed with X-ray, the patient was immobilized using an arm sling. The shoulder was immobilized for three weeks in adducted position to support soft tissue healing. Physiotherapy was started after three weeks. Conclusion. Inferior shoulder dislocation is a rare orthopedic pathology that should not be easily dismissed in post-traumatic shoulder pain. The mechanism of injury is characterized by downward force or lever mechanism on the hyperabducted arm. Orthopedic surgeons in rural areas could utilize the Traction-countertraction method.

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Section: Discussionmentioning

confidence: 99%

Inferior shoulder dislocation with greater tuberosity avulsion fracture treated with Traction-Countertraction method in a rural hospital: A case report and literature review

Kusuman

Wiryadana

Rante

2022

Intisari Sains Medis

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“…Patients with ISD typically present with the arm fully abducted and held above the head [ 3 ]. The most common complications of ISD are soft-tissue injury, fractures, and injury of the axillary nerve and brachial plexus [ 4 ]. In rare cases, patients damage the axillary artery, which can be limb-threatening.…”

Section: Introductionmentioning

confidence: 99%

Hemodynamic Instability After Axillary Artery Rupture Following Inferior Glenohumeral Joint Dislocation: A Case Report

Rasmussen,

Thorninger,

Wæver

2023

Am J Case Rep

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Patient: Male, 71-year-old Final Diagnosis: Axillary artery rupture • shoulder dislocation Symptoms: Axil swelling • compromised neurovascular status • hemodynamic instability • pain Clinical Procedure: — Specialty: Orthopedics and Traumatology Objective: Rare disease Background: Inferior shoulder dislocation is a rare type of glenohumeral joint dislocation. A serious complication to shoulder dislocation is axillary artery injury, which should be taken into consideration early to avoid potentially permanent damage. Literature on artery injury following inferior shoulder dislocation is sparse. Case Report: We report the case of a 71-year-old man with a traumatic inferior shoulder dislocation due to a fall. The patient had a medical history of stroke, and thus had a daily intake of 10 mg Warfarin. Previously, he had reported 2 anterior shoulder dislocations. The shoulder reduction was conducted under general anaesthesia after reduction with intravenous morphine sedation. Six hours after reduction, the patient showed signs of hemo-dynamic instability and a CT scan with contrast showed a suspected axillary artery rupture with a large hematoma in the right axilla. The artery rupture was confirmed with an arteriogram. The patient was successfully treated with an endovascular stent. After 3 months, the patient had normal neurovascular status in the right upper extremity and was continuing rehabilitation of the shoulder. Conclusions: This case emphasizes the importance of proper recognition and awareness of artery injury after inferior shoulder dislocation. The symptoms of artery rupture after inferior shoulder dislocation can be immediate or have a late onset. The diagnostic modalities of CT scan with contrast or arteriogram should be performed with a low threshold of suspicion after reduction. With symptoms such as enlarging hematoma in the axilla, diminished radial and ulnar pulse, sudden pain from the axilla, or signs of hemodynamic instability after reduction, diagnostic modalities should be considered.

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Primary traumatic shoulder dislocation associated with rotator cuff tear in the elderly

Prasetia

Handoko

Rosa

et al. 2022

International Journal of Surgery Case Reports

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Inferior Dislocation of Shoulder Complicated with Undisplaced Greater Tuberosity Fracture, Rupture of the Supraspinatus Tendon, and Brachial Plexus Injury in the Elderly: Case Report and Literature Review

Cited by 5 publications

References 19 publications

Inferior shoulder dislocation with greater tuberosity avulsion fracture treated with Traction-Countertraction method in a rural hospital: A case report and literature review

Inferior shoulder dislocation with greater tuberosity avulsion fracture treated with Traction-Countertraction method in a rural hospital: A case report and literature review

Hemodynamic Instability After Axillary Artery Rupture Following Inferior Glenohumeral Joint Dislocation: A Case Report

Primary traumatic shoulder dislocation associated with rotator cuff tear in the elderly

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