27 year old male presents to Janus General Hospital (where Drs. Grock and Freedman also happen to work) s/p left shoulder injury. The patient says he was playing basketball when the incident occurred. He states that he has been unable to “put down” his left arm since the injury. On exam, his left arm is abducted at about 150 degrees. You get a xray of the left shoulder and see…
you work your County magic…30 minutes later…
please provide reads for both shoulder xrays. how would you manage this patient?
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jwang
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3 Comments
greenchile · September 21, 2014 at 6:24 am
1-inferior shoulder dislocation, luxatio erecta
2-post-reduction film for shoulder dislocation
3-immobilize the shoulder in adduction and internal rotation and schedule ortho follow up within 1 week
greenchile · September 21, 2014 at 6:27 am
reduce with traction-counter traction in line with the adducted humerus. closed reduction works in most cases unless the humeral head is stuck in a tear of the inferior capsule, which usually requires operative reduction
wendyrollerblades · September 22, 2014 at 2:44 pm
i agree with greenchile. The hemoral head is dislocated inferiorly and not making contact with the glenoid. but even without the xray, the presentation the pt with their arms “locked” overhead is classic.