Domínguez-Gasca LG, Domínguez-Carrillo LG

Language: Spanish
References: 22
Page: 129-132
PDF size: 57.93 Kb.

ABSTRACT

Introduction: Inferior shoulder dislocation is a rare form of injury, accounting only for 0.5%. The mechanism of injury is a violent hiperabduction force on an already abducted limb; this dislocation is frequently associated with: greater tuberosity fracture, rotator cuff tears, brachial plexus complications, potential axillary artery injury and labrum tears. Isolated thoracodorsal nerve palsy is rare but it is possible in inferior shoulder dislocation. Clinical case: 46 years old male patient who suffered inferior shoulder dislocation and humeral great tuberosity fracture caused by sea wave, treated with reduction and 3 weeks of Velpeau immobilization, at the end Codman exercises were programmed, on the 4th week he is received by rehabilitation service where an isolated ipsilateral thoracodorsal nerve palsy is diagnosed by the posterior wall absent, and electromiographic and nerve conduction speed corroboration. He was treated with electrostimulations, muscular reeducations and global shoulder muscular strengthening, with excellent results at four months of treatment. Conclusions: Isolated thoracodorsal nerve palsy is rare, the diagnosis could be retarded in case of inferior shoulder dislocation which is also an unusual diagnosis, due to the immobilization time, both injuries must be treated with early rehabilitation.

REFERENCES

1. Himanshu S, Denolf F. Atypical subglenoid inferior glenohumeral dislocation clinically mimicking anterior dislocation. Eur J Traum 2004; 30: 259-261.

2. Saseendar S, Agarwal DK, Patro DK, Menon J. Unusual inferior dislocation of shoulder: reduction by two step maneuver: a case report. J Orthop Surg 2009; 4: 40-43.

3. Goldstein JR, Eilbert WP. Locked anterior-inferior shoulder subluxation presenting as luxatio erecta. J Emerg Med 2004; 27: 245-248.

4. Davids JR, Talbott RD. Luxatio erecta humeri: A case report. Clin Orth Rel Res 1990; 252: 144-149.

5. Middeldorpf M, Scharm B. De nova humeri luxationis specie. Clinique Eur 1859; 2: 123-226.

6. Roca LA, Ramos VJ. Luxación erecta de hombre. Rev San Mil Arg 1962; 61: 135-138.

7. Tomcovcik L, Kitka M, Molcanyi T. Luxatio erecta associated with a surgical neck fracture of the humerus. J Trauma 2004; 57: 645-647.

8. Schai P, Hintermann B. Arthroscopic findings in luxatio erecta of the glenohumeral joint: case report and review of the literature. Clin J Sport Med 1998; 8: 138-141.

9. Gardham JR, Scot JE. Axillary artery occlusion with erect dislocation of the shoulder. Injury 1979; 11: 155-158.

10. Yamamoto T, Yoshiya S, Kurosaka M, Nagira K, Nabeshima Y. Luxatio erecta-inferior dislocation of the shoulder: a report of 5 cases and a review of the literature. Am J Orthop 2003; 32: 601-603.

11. Wirth MA, Rockwood CA Jr. Subluxations and dislocations about the glenohumeral joint. In Rockwood and Green’s fractures in adults. Volume 2. 5th edition. Edited by: Bucholz RW, Heckman JD. Philadelphia: Lippincott Williams & Wilkins; 2001: 1109-1207.

12. Mallon WJ, Bassett III FH, Goldne RD. Luxatio erecta: the inferior glenohumeral dislocation. J Orthop Trauma 1990; 4: 1924-1927.

13. Lev-El R, Rubinstein AZ. Axillary artery injury in erect dislocation of the shoulder. J Trauma 1981; 21: 323-325.

14. Matsumoto K, Ohara A, Yamanaka K, Takigami I, Naganawa T. Luxatio erecta (inferior dislocation of the shoulder): A report of two cases and a review of the literature. Injury Extra 2005; 36: 450-453.

15. Schai P, Hintermann B. Arthroscopic findings in luxatio erecta of the glenohumeral joint: case report and review of the literature. Clin J Sport Med 1998; 8: 138-141.

16. Fery A, Sommelet J. Erect dislocation of the shoulder (luxatio erecta humeri). General review apropos of 10 cases. Int Orthop 1987; 11: 95-103.

17. Ballesteros LE, Ramírez LM. Variations of the origin of collateral branches emerging from the posterior aspect of the brachial plexus. JBP & PNI 2007; 2: 2-14.

18. Fazan VPS, Amadeu AS, Caleffi AL, Rodrigues OA. BP variations in its formation and main branches. Acta Cirúrgica Brasileira 2003; 18: 14-18.

19. Tubbs RS, Loukas M, Shahid K, Judge T, Pinyard J, Shoja MM, Slappey JB, McEvoy WC, Oakes WJ. Anatomy and quantitation of the subscapular nerves. Clin Anat 2007; 1: 29-36.

20. Gupta M, Goyal N, Harjeet. Anomalous communications in the branches of BP. J Anat Soc India 2005; 54: 22-25.

21. Lotze MT, Duncan MA, Gerber LH, Woltering EA, Rosenberg SA. Early versus delayed shoulder motion following axillary dissection: A randomized prospective study. Ann Surg 1981; 193: 288-295.

22. Wu P B, Robinson T, Kingery WS, Date ES. Thoracodorsal nerve conduction study. Am J Phys Med Rehabil 1998; 77: 296-298.