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Unusual inferior dislocation of shoulder: reduction by two-step maneuver: a case report

S Saseendar email, Dinesh K Agarwal email, Dilip K Patro email and Jagdish Menon email

Department of Orthopedics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India

author email corresponding author email

Journal of Orthopaedic Surgery and Research 2009, 4:40doi:10.1186/1749-799X-4-40

Published: 3 November 2009

Abstract

Dislocation of the shoulder is the commonest of all large joint dislocations. Inferior dislocation constitutes 0.5% of all shoulder dislocations. It characteristically presents with overhead abduction of the arm, the humerus being parallel to the spine of scapula. We present an unusual case of recurrent luxatio erecta in which the arm transformed later into an adducted position resembling the more common anterior shoulder dislocation. Such a case has not been described before in English literature. Closed reduction by the two-step maneuver was successful with a single attempt. MRI revealed posterior labral tear and a Hill-Sachs variant lesion on the superolateral aspect of humeral head. Immobilisation in a chest-arm bandage followed by physiotherapy yielded excellent results. The case is first of its kind; the unusual mechanism, unique radiological findings and alternate method of treatment are discussed.


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