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Clinical and anteroposterior radiographic presentation of luxatio erecta of the left shoulder. The arm is abducted and overheaded (erect arm posture), with the humerus almost parallel to the spine of scapula (since various degrees of abduction are possible) and the elbow fl exed with the forearm lying on the head (sometimes it is termed " hands up " position). The head of the humerus faces inferiorly and it is locked inferior to glenoid. No associated bone injuries were detected.
Source publication
Traumatic inferior dislocation of the shoulder (also termed “luxatio erecta”) is a very rare injury. The correct diagnosis may be overlooked and results after reduction can often result in signifi cant morbidity of the affected joint. It is described in a clinical case in which a male adult reported a luxatio erecta that was correctly diagnosed and...
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Citations
... Two mechanisms of this lesion have been described, the indirect and direct, both involve the hyperabduction of the affected arm, as in the falls from height [4]. The indirect mechanism is the most common (70%) [7,8] and is presented with shoulder hyperabduction in contact with the proximal humerus and acromion, which generates the rupture of the inferior portion of the glenohumeral capsule that leads to inferior dislocation of the humeral head [7,8]. The direct mechanism is associated with high-energy events in which the humeral head is directed down, tearing the glenohumeral ligaments [6]. ...
... Two mechanisms of this lesion have been described, the indirect and direct, both involve the hyperabduction of the affected arm, as in the falls from height [4]. The indirect mechanism is the most common (70%) [7,8] and is presented with shoulder hyperabduction in contact with the proximal humerus and acromion, which generates the rupture of the inferior portion of the glenohumeral capsule that leads to inferior dislocation of the humeral head [7,8]. The direct mechanism is associated with high-energy events in which the humeral head is directed down, tearing the glenohumeral ligaments [6]. ...
... The physical exam is essential for the diagnosis of this pathology [8]. Radiological support is necessary to confirm the diagnosis and to rule out possible complications or associated injuries [4]. ...
Luxatio erecta (inferior shoulder dislocation) is a rare entity, infrequent, but with a good prognosis. There are two mechanisms for this injury to occur, by an indirect force, which is the most frequent, and by a direct force. Both involve hyperabduction of the arm. The clinical presentation is characteristic and unmistakable. Diagnosis is clinical, but imaging tests are useful to rule out associated injuries and complications. The treatment of choice is closed reduction and, in most cases with favorable results. We present the case of an 83-year-old woman who went to the emergency room with a diagnosis compatible with Luxatio erecta of the glenohumeral joint. Subsequently, a closed reduction was performed with good results. The patient is currently undergoing physical therapy and rehabilitation.
... However, it has been observed that it can sometimes be confused with the more common anterior dislocation of the shoulder, especially the subglenoid variant. 3 Additional scapular Y view and axillary views allow appropriate evaluation of the relationship of the humeral head to the glenoid and further show possible fractures of the glenoid, coracoid process and humeral head. 4 There is even a report of a missed diagnosis due to lack of classical 'overhead-abducted limb' presentation leading to delay in management. ...
Luxatio erecta accounts for only 0.5% of all shoulder dislocations. More than 150 cases have been described in the literature, focusing mainly on the method of reduction and/or associated complications. Some of the well-described complications include injuries to the humeral head, glenoid, clavicle, rotator cuff, capsules and ligaments, brachial plexus and axillary artery/vein. Among these, rotator cuff injuries are reported to occur in about 80% of cases. However, in the majority of instances, cuff injuries have been managed conservatively and have been reported to apparently provide optimal functional outcomes. We report our experience with two cases of luxatio erecta associated with massive rotator cuff injuries, which were evaluated and further managed by arthroscopic repair. The emphasis in these cases is to define cuff injuries and proceed based on patients' age, demands and characteristics of the cuff tears. Arthroscopic evaluation and cuff repairs should be contemplated in these patients, to improve shoulder functions. 2015 BMJ Publishing Group Ltd.
Luxatio erecta, inferior dislocation of the glenohumeral joint, is a rare type of injury (1% of shoulder
dislocations). In most cases the injury is caused by falling while the upper extremity is hyperabducted. We introduce two cases of consecutive patients with the same rare type of injury – walking the dog. According to the literature, the most frequently used method for the reduction of inferior shoulder dislocation is tractioncountertraction under sedation. If the patient has no other reason to be under general anesthesia or sedation, we recommend, however, administration of local anesthetics and using a less traumatic two-step manoeuvre to reduce inferior shoulder dislocation – luxatio erecta.
