Abstract

Introduction. 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. Presentation of Case. 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. Discussion. 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. Conclusion. 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.

Highlights

  • IntroductionThe most common aetiology is falling for luxatio erecta humeri

  • Inferior dislocation of the glenohumeral joint, known as luxatio erecta humeri, and posterior hip dislocation are both rare presentations in the emergency department

  • Close questioning revealed the mechanism of his injury as direct axial loading force on a fully abducted upper extremity while he was protecting his body from the wreckage

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Summary

Introduction

Inferior shoulder dislocation is an extremely rare disorder in the emergency department, accounting for 0.5% of all glenohumeral dislocations [1]. A man aged 28 years presented with his right upper extremity abducted at the shoulder, flexed at the elbow, pronated at the forearm, and with his hand behind his head (Figure 1). He was in a building collapse and was rescued 1 hour afterwards. Close questioning revealed the mechanism of his injury as direct axial loading force on a fully abducted upper extremity while he was protecting his body from the wreckage. His medical history was otherwise unremarkable and he was not using any medication. A slight restricted range of motion in the hip and full range of motion in the shoulder were noted

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