A 19-year-old motorcyclist is brought in by EMS after losing control of his bike and flying through the air, only to strike a pole with his extended and abducted arm. The helmeted patient, immobilized, is awake, alert and oriented. He complains of pain in his right arm and chest. Physical exam shows a young man in a c-collar, with his right arm extended, elbow flexed, and his hand behind his head. When you ask him to put his arm down, he says he can’t.
What is the injury?
answer
Inferior shoulder dislocation: luxatio erecta humeri. This RARE injury is sustained when the arm is forcefully abducted. The head of the humerus levers our of the glenoid fossa, resting below the inferior glenoid rim. Reduction can be performed with reverse traction-counter-traction. This injury is strongly associated with glenoid rim injuries, severe soft tissue injures, brachial plexus injuries and humeral neck fractures.
Tintinalli, 7th Edition
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