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Luxatio erecta - inferior shoulder dislocation with fracture of proximal humerus

Case contributed by Pir Abdul Ahad Aziz Qureshi
Diagnosis certain

Presentation

Hit by her dog, loses balance and fell on the ground. Arm held in extended position.

Patient Data

Age: 65 years
Gender: Female

The humeral head is dislocated inferiorly (technically anteroinferior) with comminuted fracture involving the proximal humerus with displaced greater tuberosity. Note the abducted position of the humerus.

Post-reduction x-ray of the shoulder dislocation. No bony Bankart lesion is identified. Comminuted fracture of the proximal humerus.

Case Discussion

Inferior shoulder dislocation, also called luxatio erecta, is the least common type of shoulder joint dislocation. The arm is held in abducted position in inferior shoulder dislocation due to the humeral head stuck under the bony labrum. 

Inferior dislocation can mimic subglenoid anterior dislocation in which the humeral head lies directly below the glenoid process of the scapula in the AP and lateral projections.

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