Dislocation Of Right Shoulder Research Articles

Recurrent Heart Attacks in a Young Lady

24-year-old woman presented to our hospital with chest pain, new ECG changes and high troponin suggestive of non-ST Myocardial infarction, patient gave history of another two heart attacks at the age of 20 and 21, on both occasions, she was treated with angioplasty and no stenting. Her past medical history was significant for recurrent meniscal tear on both knees which was treated conservative, when patient was 15-year-old, she was diagnosed as carotid–cavernous fistula and Treated with endovascular therapy, her family history was noted for her sister having small bowel rupture at the age of 18 year, her brother had two strokes at the age of 18 and 19, patient also was known to have recurrent dislocation of right shoulder and delayed wound healing. Examination showed scattered bruising, blue sclera, hyperelasticty of skin over elbow joints, MRA of whole body showed aneurysm of both internal iliac vessels, coronary CT showed aneurysm in the left anterior descending and right coronary arteries, differential diagnosis was discussed with the patient who gave a consent for genetic study which came positive for COL3A1 and confirmed the diagnosis of Vascular Ehlers Donals Syndrome (formally called Ehlers Donals Syndrome type 4). Patient agreed for genetic counselling, and first-degree family agreed for genetic testing, in the article we will report the case and discuss the differential diagnosis.

SAT-342 Humerus Fracture & Dislocation of Right Shoulder Following a Seizure in Non-Epileptic Patient Due to Hypoparathyroidism

Introduction: Hypoparathyroidism is a rare disease. The most common etiology of hypoparathyroidism is the surgical resection of the parathyroids.Primary hypoparathyroidism can cause a wide spectrum of manifestations, mainly due to low serum calcium effect on internal organs, and directly correlates with the rate of development of hypocalcemia.Parathyroid Hormone (PTH) is one of the key regulators of the rate of bone remodeling. A reduction or absence of circulating PTH leads initially to a decrease in bone resorption then to a coupled reduction in bone formation. Case Presentation A 36-year-old male nurse in primary health care, not known to have any medical illness, presented to the emergency department with generalized tonic-clonic seizures associated with right shoulder dislocation and communicated fracture of the humerus. However, the day before his presentation, he has had two episodes of convulsion, but he did not seek medical attention.He had developmental delay in walking and teeth eruption as well as frequent generalized tonic-clonic which were treated by traditional healer. This information could point out to the possibility of congenital origin.Upon arrival to the emergency department, he has teeth decay all over his oral cavity with right shoulder dislocation and right humerus fracture. Chvostek sign and trousseau sign were positive.The patient was treated initially with calcium gluconate intravenously followed by oral treatment of calcium carbonate 1.2 g three times daily and alfacalcidiol 1 mcg twice daily and upon discharge teriparatide 20 mcg subcutaneously daily was given.ConclusionTreatment of hypoparathyroidism with recombinant parathyroid hormone may reduce bone mineral density (BMD) but concomitantly strengthen bone.This is a treatable disorder that may have catastrophic results if overlooked but also its symptoms may be completely reversed with prompt treatment.It is of utmost importance routine vitamin D, phosphorous, and calcium monitoring, as well as renal calcium excretion evaluation to prevent complications of overtreatment with CA and active Vit D.References• Bilezikian JP, Khan A, Potts JT Jr, Brandi ML, Clarke BL, Shoback D, et al. Hypoparathyroidism in the adult: epidemiology, diagnosis, pathophysiology, target- organ involvement, treatment, and challenges for future research. J Bone Miner Res. 2011;26(10):2317-37.

Shoulder Injury - Bicycling

HISTORY: A 44-year-old left-hand dominant male triathlete sustained a right shoulder injury in a biking accident. He was riding his bike down the road when a car door opened, and he hit the door causing his bike to flip over. He immediately had right shoulder pain and could not move his arm. He had no previous history of shoulder injury or pain. He was within blocks of his orthopedist so he went to the office where radiographs were taken. He was told they were normal and to do ROM exercises. After 2 weeks he was still symptomatic so an MRI was obtained. He presented to our clinic 3 weeks after the injury. He was very active and wanted to return to triathlons. PHYSICAL EXAMINATION: He was in no distress. He had no swelling and vascular examination was normal. He had extremely limited range of shoulder motion with no external rotation without pain. He was neurologically intact including motor and sensation to his right extremity. He had full range of motion of his fingers, wrist and elbow. DIFFERENTIAL DIAGNOSIS: Fracture of scapula Fracture of proximal humerus Dislocated shoulder TEST AND RESULTS: Plain anterior-posterior and axillary radiographs of the shoulder: chronic locked posterior dislocation of right shoulder MRI and CT of shoulder confirms diagnosis with no fractures FINAL WORKING DIAGNOSIS: Fixed sub-acute posterior dislocation of right shoulder. TREATMENT AND OUTCOMES: Four weeks after injury, obtained a closed reduction under anesthesia but stable only in abducted position. Consequently applied body spica cast with arm in abduction and slight external rotation. Arm in body spica cast for 5 weeks. Allowed passive and active range of motion of wrist, hand, and fingers, but not elbow or shoulder. Vicodin for pain. Arm portion of the cast bivalved at 2 weeks to allow for elbow range of motion. Cast removed at 5 weeks post-op. Radiographs before and after cast removal showed the humeral head to be in good position. Transitioned to external rotation brace and started gentle ROM of shoulder. Radiographs at 2 months showed the humeral head was concentric in the glenoid. External rotation brace discontinued. At 3 months post-op, started physical therapy and returned to indoor biking, running, and swimming with the exception of overhead strokes. Returned to triathlon events at 13 months post-op.

Bipolar dislocation of the clavicle

Bipolar dislocation of the clavicle at acromioclavicular and sternoclavicular joint is an uncommon traumatic injury. The conservative treatments adopted in the past is associated with redislocation dysfunction and deformity. A 41 years old lady with bipolar dislocation of right shoulder is treated surgically by open reduction and internal fixation by oblique T-plate at sternoclavicular joint and Kirschner wire stabilization at acromioclavicular joint. The patient showed satisfactory recovery with full range of motion of the right shoulder and normal muscular strength. The case reported in view of rarity and at 2 years followup.

IPSILATERAL SIMULTANEOUS SHOULDER AND ELBOW DISLOCATION a case report

Ipsilateral dislocation of the shoulder and elbow joints is a rare and complex injury. Only six patients have been reported in the international literature with ipsilateral dislocation of the shoulder and elbow. Here, we reported a 48 year-old woman who suffered ipsilateral shoulder and elbow dislocation. The patient first presented to a regional hospital and the radiographs taken following the initial evaluation revealed posterolateral dislocation of right elbow. The reduction of the dislocated elbow was performed at that facility. However, since no radiographic examination of the injured shoulder had been carried out, the dislocation injury of the shoulder was missed. Three days later the patient presented to Tepecik Training and Research Hospital emergency Department (Izmir-Turkey), complaining of shoulder pain. Radiographs showed the missed anterior dislocation of right shoulder, which had been reduced under general anaesthesia. At final follow-up, 2.5 years later, the elbow and the shoulder were pain free and had full range of motion. Following a high energy trauma in upper extremities, radiographic examination of the shoulder, elbow and wrists must be performed in case of suspicion.

Dislocation of the Shoulder with Ipsilateral Humeral Shaft Fracture - A Case Report -

Dislocation of the shoulder with ipsilateral humeral shaft fracture is very rare, but serious injury that requires emergent care. There have been approximately 20 cases reported in the English literature, but it has never been reported in Korea. We report a case of dislocation of right shoulder with ipsilateral humeral shaft fracture which was successfully treated by closed reduction of the shoulder under general anesthesia and internal fixation with antegrade interlocking intramedullary nailing for the humeral shaft fracture.

Pseudoaneurysm Of Axillary Artery Following Shoulder Dislocation

Axillary arterial pseudoaneurysms are uncommon. Although infrequently seen as an iatrogenic complication very few cases have been reported following postero-inferior dislocation of the shoulder joint. We present one such case, which was successfully managed by surgical intervention. Although uncommon, pseudoaneurysms should not be forgotten after trivial trauma. Upper limb pseudoaneurysms should be recognised early because of the risk of early vascular, neurological compromise and risk potential serious long-term sequelae . PSEUDOANEURYSM OF AXILLARY ARTERY FOLLOWING SHOULDER DISLOCATION A 71-year-old lady presented to A/E with a Road Traffic Accident having been side swiped by a car. Initial assessment was normal. Radiological examination of shoulder (figure 1) showed postero-inferior dislocation of right shoulder.