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Luxatio erecta (inferior glenohumeral dislocation) is an uncommon type of shoulder dislocation. Early recognition and reduction is important to prevent neurovascular sequelae. We report two cases of luxatio erecta in order to describe the clinical presentation and reduction technique in the Emergency Department.
OBJECTIVE: To review the outcomes of arthroscopic stabilisation procedures for the treatment of recurrent anterior shoulder dislocation. DESIGN: Retrospective study. SETTING: Regional hospital, Hong Kong. PATIENTS: Patients receiving arthroscopic stabilisation procedures for recurrent anterior shoulder dislocation between 1999 and 2003. MAIN OUTCOME MEASURES: Functional outcomes including pain, range of motion, and activity level were assessed using the Constant score. Intra-operative findings were also discussed. RESULTS: A total of 18 arthroscopic stabilisation procedures were performed for the treatment of recurrent shoulder instability. Two cases converted to open procedures were excluded from this review. The overall outcomes were good and seven patients reported a full recovery. Fourteen out of 16 patients reported minimal or no pain, and the mean Constant score was 80. There were no cases of re-dislocation and no major complication was noted. CONCLUSION: All the reviewed patients had a satisfactory functional recovery. Therefore, we believe that the use of arthroscopic stabilisation procedure can produce a favourable outcome for appropriate shoulder pathologies.
A reduced retroversion angle of the humeral head may predispose to recurrent anterior shoulder dislocation and may also be a factor in persistent instability after soft-tissue repair. We performed rotational osteotomy of the proximal humerus in 20 patients with recurrent anterior shoulder dislocations (10 traumatic, 10 non-traumatic) and a decreased retroversion angle of the humeral head. The mean preoperative retroversion angle was 12 degrees, which was increased after surgery to a mean value of 32 degrees. All patients regained a normal range of shoulder motion and normal function within three months after surgery. At the five-year review all shoulders were stable, pain-free and had no radiological signs of osteoarthritis.
PURPOSE: To establish radiographic criteria to choose the most appropriate technique of reduction for each type of anterior glenohumeral dislocation, and to determine the type of dislocation which requires general anesthesia. MATERIAL AND METHODS: Radiography in two different projections was performed in 67 patients with antero-inferior shoulder dislocations before a reduction attempt. The method proposed by BOss-HOLZACH-MATTER was used as the primary technique for all shoulder dislocations. RESULTS: Most subcoracoid dislocations (84.4%) could be reduced by the BOss-HOLZACH-MATTER method while only a few subglenoid dislocations (15.8%) were reducible by this technique. Displaced associated fractures significantly reduced the success rate of the reduction attempts. CONCLUSION: Anterior dislocations of the shoulder require different methods of reduction depending upon the type (sub-group) of dislocation. Reduction of subglenoid dislocations with associated greater tuberosity fracture should be performed under general anesthesia to avoid head-splitting fracture.
PURPOSE: To report 2patients with ulnar dimelia. METHODS: Plain radiographs (2patients), angiography (1patient), MR (2patients), CT (2patients) with 3Dreconstruction (1patient) were performed. RESULTS: Unilateral polydactyly with absence of the thumb, ulnar duplication with absence of radius were observed in both patients. Shoulder dislocation was present in one patient. Vascular anomalities were observed in one patient who underwent angiography but did not interfere with polydactyly surgical treatment and pollicisation. CT with 3D helped in delineating the elbow and shoulder bone abnormalities and thus in planning elbow osteotomies. MR was helpful in imaging muscle anatomy. CONCLUSIONS: Ulnar dimelia or "mirror hand" is a rare congenital disorder of the upper limb. Approximately 70cases have been reported, including 3 with shoulder dislocation. A multimodality imaging approach, exploring the various aspects of the malformation is mandatory to help the surgeon in order to obtain a functional and aesthetic upper limb after complex surgical procedures taking into account the various aspects of the malformation.
Bilateral locked posterior fracture dislocation of the shoulders is one of the least common injuries of the shoulder, and this injury has been suggested to be pathognomonic of seizures when diagnosed in the absence of trauma. The authors present a case of idiopathic bilateral locked posterior fracture dislocations of the shoulder, along with a review of the medical literature. The authors also present the "triple E syndrome," describing the possible etiologies of this injury: epilepsy (or any convulsive seizure), electrocution, or extreme trauma.
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