Bilateral inferior dislocation of the shoulder joint (bilateral luxatio erecta humeri): Case report

Abstract

Introduction: Lower dislocation of the shoulder joint (luxatio erecta humeri) is rare, with an incidence of 0.5% in relation to all dislocations. This paper shows a patient with bilateral lower luxation of the shoulder joint, explains the clinical presentation, diagnosis and treatment of this rare dislocation. Case report: The patient presented to the Emergency Department after the accidental fall from a height onto a flat surface. During the fall, he put both of arms in abducted position, overhead. On examination, both upper arms were hyper-abducted with moderate external rotation, elbows joints were in flexion, and forearms in incomplete pronation. Both of humeral heads were palpable in the axillary fossa and attached overside of the chest wall. Finger movements were difficult, to impossible, to the right side more prominent. Radiography examination confirmed luxatio erecta humeri bilateralis. After that, we performed a closed reduction using traction/countertraction method. After the orthopedic repositioning we recorded weakness of the upper extremities. Neurological assessment proved bilateral brachial plexopathy, prominent on the right-side. After diagnostic and therapeutic procedures, the patient wase immobilized by Desault bandage. Conclusion: The clinical diagnosis of luxatio erecta humeri is characteristic and easily recognized. Radiography is crucial for the diagnosis for this type of dislocation. Neurological complications were recorded and treated after repositioning. Rehabilitation therapy is still in progress, and further follow-up will give final evidence about the long-term prognosis.