What's the Diagnosis? By Dr. Katie Selman

Wed, 01/01/2020 - 3:00pm
Author: 
Katie Selman, MD
Editor: 
Jillian Smith MD

A 76 yo F presents to the ED w/ L shoulder pain. While walking her dog, the dog pulled hard on the leash and she fell, developing sudden onset L shoulder pain. On exam, her L arm is positioned above her head and she is unable to range it. X-ray is shown below. What's the diagnosis? (scroll down for answer)

 

 

 

Answer: Inferior Shoulder Dislocation or "Luxatio Erecta"
  • Rarest type of shoulder dislocation
  • Mechanism of injury- hyperabduction
  • Classically, patients cannot adduct their arm
  • Complications:
    • Rotator cuff tears (12-15% patients)
    • Axillary artery injury
    • Brachial plexus injury
    • Humeral head fracture
  • Treatment
    • Immediate reduction (may require open reduction)
    • Immobilization
    • Orthopedic follow up to assess rotator cuff

 

 

References:

Malik S, Pirotte A. Shoulder. In: Sherman SC. eds.Simon’s Emergency Orthopedics, 7eNew York, NY: McGraw-Hill; 2014