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JBJS Case Connect 2021 04 22;11(2). Epub 2021 Apr 22.

Department of Orthopaedic Surgery, Division of Shoulder and Elbow, New York University Langone Health, Grossman School of Medicine, New York, New York.

Case: We report a rare variant of sternoclavicular joint (SCJ) dislocation, namely locked anterior-inferior dislocation, with unique clinical, radiographic, and intraoperative findings. In this variant, the medial clavicle was displaced anteriorly and inferiorly and locked in the manubrial-intercostal space, with corresponding mechanical dysfunction of the ipsilateral shoulder girdle joints. Symptoms unique to this variant included painful neck spasms and limited glenohumeral elevation. Read More

Bone Joint J 2020 Dec;102-B(12):1620-1628

Department of Trauma and Orthopaedic Surgery, BG Unfallklinik Frankfurt am Main, Frankfurt, Germany.

Aims: To evaluate the outcomes of terrible triad injuries (TTIs) in mid-term follow-up and determine whether surgical treatment of the radial head influences clinical and radiological outcomes.

Methods: Follow-up assessment of 88 patients with TTI (48 women, 40 men; mean age 57 years (18 to 82)) was performed after a mean of 4.5 years (2. Read More

Cureus 2020 Oct 17;12(10):e10996. Epub 2020 Oct 17.

Orthopedic Surgery, Faculty of Medical Science, Lebanese University, Beirut, LBN.

Missed or chronic bilateral anterior shoulder dislocation is a rare presentation, usually secondary to epileptic attack. We present herein an exceptional case of this injury pattern, associated with bilateral displaced fracture of the coracoid process, and unilateral rupture of the long head of biceps. Treatment consisted of open reduction through osteotomy of the lesser tuberosity, with additional stabilization of the glenohumeral joint, using the Latarjet procedure by transposition of the coracoid fragment with its attached conjoint tendon to the antero-inferior glenoid rim. Read More

JBJS Case Connect 2020 Jul-Sep;10(3):e1900231

1Department of Orthopedic Surgery, Shoulder and Elbow, Federal University of Paraná-UFPR, Curitiba, Brazil.

Case: A 69-year-old man fell from a height, resulting in direct axial loading while both shoulders were fully abducted. He was referred to the surgical ward, and both shoulders were reduced by closed reduction using the traction-countertraction maneuver. After little improvement of complaints of pain in the right shoulder over 45 days, magnetic resonance demonstrated traumatic rupture of the supraspinatus. Read More

Am J Case Rep 2020 Jun 18;21:e923727. Epub 2020 Jun 18.

Department of Orthopaedics, University Hospital, Patras Medical School, Patras, Greece.

BACKGROUND Luxatio erecta humeri (LEH) is a rare injury present in only 0.5% of shoulder dislocations. Much of the relevant literature is focused on the initial management and proper reduction techniques, although the prevalence of associated injuries can reach 80%. Read More

J Shoulder Elbow Surg 2020 Oct 4;29(10):2111-2122. Epub 2020 Jun 4.

PanAm Clinic, University of Manitoba, Winnipeg, Manitoba, Canada.

Background: Glenoid lateralization has been shown to be the most imortant factor in maximizing passive range of motion and shoulder stability while preventing scapular impingement and notching. We aimed to evaluate mid- to long-term functional and radiologic outcomes after bony increased-offset-reverse shoulder arthroplasty (BIO-RSA) using a Grammont-style (medialized) humeral implant.

Methods: The study included 143 consecutive shoulders (140 patients; mean age, 72 years) treated with a BIO-RSA for rotator cuff deficiency. Read More

Arthroscopy 2020 05;36(5):1271-1272

More than 100 surgical techniques have been described for the reconstruction of the coracoclavicular ligament complex. None of the techniques appears superior, but double-button fixation for acute high-grade acromioclavicular dislocations has become an attractive option. The clinical outcomes are good to excellent, and the return to physical activity and sport is above 90%. Read More

Acta Ortop Mex 2019 May-Jun;33(3):182-184

Universidad de Rosario. Colombia.

Isolated lesion of the axillary (or circumflex) nerve is infrequent, this is usually associated with a brachial plexus injury. In our institution, in a period comprised between the years 2015-2017, a frequency of only 0.4% of this injury has been observed. Read More

Orthop Traumatol Surg Res 2020 02 9;106(1):67-75. Epub 2019 Dec 9.

Department of Orthopaedic Surgery, Dankook University College of Medicine, Cheonan, Korea. Electronic address:

Background: The conventional AO hook locking compression plate (LCP) (Synthes, Solothurn, Switzerland) has only three holes for lateral fragments; therefore it is not suitable for use during the fixation of small-comminuted fragments in some cases. Recently, a novel hybrid hook LCP (TDM, Seoul, Korea) was developed to overcome this limitation. Here, we evaluated the clinical and radiologic outcomes of a novel hybrid hook LCP for Neer type V distal clavicle fractures compared to the outcomes of a conventional AO hook plate. Read More

J Emerg Med 2019 Oct 30. Epub 2019 Oct 30.

Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan; Department of Pharmacology, University of Michigan, Ann Arbor, Michigan.

Background: Shoulder pseudodislocation, or "drooping shoulder," presents with acute pain and deformity of the joint, with radiographs demonstrating inferior subluxation of the humeral head relative to the glenoid fossa. The diagnosis must be made promptly and distinguished from true glenohumeral dislocation, both to avoid unnecessary attempts at closed reduction and to facilitate investigation of the underlying cause, which may include septic arthritis, hemarthrosis, or other emergent etiologies. Point-of-care ultrasound (POCUS) may be useful in the evaluation of emergency department (ED) patients with suspected pseudodislocation. Read More

Knee Surg Sports Traumatol Arthrosc 2020 Jul 17;28(7):2316-2324. Epub 2019 Oct 17.

Orthopaedic Department, Aalesund Hospital, Aalesund, Norway.

Purpose: This novel arthroscopic subscapular sling procedure stabilizes the shoulder using a semitendinosus graft to create a sling around the subscapular tendon, which provides both static and dynamic stability. The aim of the study was to evaluate the biomechanical stability of the subscapular sling procedure in human cadaveric shoulders. The hypothesis was that the sling offers an equal stabilizing effect and range of motion compared to an arthroscopic Bankart repair. Read More

Arthrosc Tech 2019 Jul 11;8(7):e697-e703. Epub 2019 Jun 11.

Shoulder Arthroscopy and Sports Medicine Unit, Orthopedics Department, Zagazig University Hospitals, Zagazig, Egypt.

Chronic acromioclavicular joint dislocations (ACJDs) develop when there is failure of conservative treatment, failed surgical treatment of acute ACJD, or simply missing the treatment in the acute healing phase. There is wide agreement that mechanical fixation alone in chronic ACJD is not sufficient and biological augmentation is necessary. Various arthroscopic techniques for reconstruction of the coracoclavicular ligament have been described, but allografts are expensive, are not available in all centers, carry the risk of disease transmission, and are "dead tissue" with a poor capacity for healing. Read More

World J Clin Cases 2019 Apr;7(7):849-854

Department of Radiology and Medical Imaging, University of Medicine and Pharmacy "Victor Babes", Timis, Timișoara 300736, Romania.

Background: Open dislocation of the glenohumeral joint is a very rare complication with only six cases described in the literature. Most cases resulted in severe complications like avascular necrosis of the humeral head or septic arthritis with poor functional results. The "mandatory" treatment of choice is surgery, with accurate debridement and reconstruction of the damaged soft tissues. Read More

J Bone Joint Surg Am 2018 Nov;100(22):1912-1918

The University of Edinburgh, Edinburgh, United Kingdom.

Background: Nonoperative management of complete acromioclavicular (AC) joint dislocation has yielded reasonable results, although patients may report dissatisfaction with the outcome. The purpose of this prospective, randomized, controlled trial was to compare patient outcome following nonoperative care versus operative treatment with open reduction and tunneled suspension device (ORTSD) fixation for acute, type-III or IV disruptions of the AC joint.

Methods: Sixty patients aged 16 to 35 years with an acute type-III or IV disruption of the AC joint were randomized to receive ORTSD fixation or nonoperative treatment, following a power analysis to determine sample size. Read More

Am J Emerg Med 2018 10 27;36(10):1926.e3-1926.e5. Epub 2018 Jun 27.

Department of Orthopedics, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China. Electronic address:

Luxatio erecta humeri is the rarest type of glenohumeral dislocation, which has been reported to be associated with humeral fracture, rotator cuff tear and neurovascular injury. To our knowledge, a single-sided acute inferior glenohumeral dislocation associated with humeral greater tuberosity fracture and axillary nerve injury has not yet been reported. Here, we reported a traumatic first-time inferior shoulder dislocation from a construction worker who got hyperflexion of the left shoulder when fell and grasped the railing causing. Read More

Skeletal Radiol 2019 Mar 27;48(3):467-473. Epub 2018 Aug 27.

Department of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore.

Luxatio erecta humeri (LEH), also known as inferior shoulder dislocation, is uncommon, comprising about 0.5% of all cases of shoulder dislocation. Synchronous bilateral LEH is exceedingly rare and, to our knowledge, there are no descriptions of axillary nerve injury on magnetic resonance imaging (MRI) following LEH. Read More

BMJ Case Rep 2018 Jun 20;2018. Epub 2018 Jun 20.

Center for Musculoskeletal Surgery, Charite Universitatsmedizin Berlin Campus Virchow-Klinikum, Berlin, Germany.

In the field of traumatic shoulder dislocations, this report of a 61-year-old female patient discusses the case of an acute locked superior shoulder dislocation in conjunction with a chronic rotator cuff arthropathy resulting from a low-energy fall on the outstretched and abducted arm. Radiological assessment revealed a complex combination of associated bony injuries including a fracture of the upper part of the glenoid and an impaction fracture of the inferior articular surface of the humeral head. Closed reduction and immobilisation were not successful in obtaining joint stability. Read More

Clin Orthop Relat Res 2018 08;476(8):1622-1629

Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT, USA.

Background: Instability is the most common complication after reverse total shoulder arthroplasty (rTSA). In the native glenohumeral joint, in addition to full dislocations, more subtle forms of instability exist. However, the incidence of more subtle forms of instability, the factors associated with instability, and the effect of instability on validated outcome scores after rTSA remain poorly understood. Read More

Eur J Trauma Emerg Surg 2018 Feb 3;44(1):45-51. Epub 2017 Oct 3.

Department of Orthopaedics, La Trobe Regional Hospital, Traralgon, VIC, 3844, Australia.

Introduction: Traumatic inferior shoulder dislocation (ISD) is rare, estimated to occur in 0.5% of all shoulder dislocations. We describe the demographics, natural history and outcome of this injury. Read More

Musculoskelet Surg 2018 Apr 31;102(1):73-79. Epub 2017 Aug 31.

Department of Orthopedic Surgery, Assistance Publique - Hôpitaux de Paris, Bichat - Claude Bernard Hospital, Paris Diderot University, 46 Rue Henri Huchard, 75018, Paris, France.

Purpose: To compare clinical and radiological outcomes between two endoscopically assisted double-button techniques in high-grade acute acromioclavicular separations.

Methods: A retrospective single-center study was conducted in patients with acute acromioclavicular joint dislocation Rockwood types III and V, from 2009 to 2014. All were treated endoscopically, with a 1-year minimum follow-up. Read More

Int J Surg Case Rep 2017 17;31:124-127. Epub 2017 Jan 17.

The Department of Orthopaedics and Trauma, National Hospital (Riyadh Care), Riyadh, Saudi Arabia; The Department of Surgery, King Saud University, Riyadh, Saudi Arabia. Electronic address:

Introduction: Bilateral inferior shoulder dislocation is rare; but the dislocation is almost always reducible by closed means. We present a unique case of irreducible bilateral inferior shoulder dislocation.

Presentation Of Case: A 35-year old male fell down from height. Read More

Case Rep Orthop 2016 19;2016:6910945. Epub 2016 Dec 19.

Istanbul Faculty of Medicine, Department of Orthopaedics and Traumatology, Istanbul University, Istanbul, Turkey.

Inferior dislocation of the glenohumeral joint, known as luxatio erecta humeri, and posterior hip dislocation are both rare presentations in the emergency department. The most common aetiology is falling for luxatio erecta humeri. The aim of this manuscript was to present a unique case in terms of luxatio erecta humeri, which has a different aetiology, treatment method, and concomitant injury. Read More

Duodecim 2016 ;132(13-14):1287-92

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. Read More

Am Fam Physician 2016 Jul;94(2):119-27

Rutgers University Robert Wood Johnson Medical School, New Brunswick, NJ, USA.

Acute shoulder injuries in adults are often initially managed by family physicians. Common acute shoulder injuries include acromioclavicular joint injuries, clavicle fractures, glenohumeral dislocations, proximal humerus fractures, and rotator cuff tears. Acromioclavicular joint injuries and clavicle fractures mostly occur in young adults as the result of a sports injury or direct trauma. Read More

Chin J Traumatol 2015 ;18(3):181-3

Department of Orthopaedic Surgery and Radiodiagnosis, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh 202002, India.

Inferior glenohumeral dislocation is the least common type of glenohumeral dislocations. It may be associated with fractures of the adjacent bones and neurovascular compromise. It should be treated immediately by close reduction. Read More

Skeletal Radiol 2015 Sep 9;44(9):1387-91. Epub 2015 Jun 9.

Department of Radiology, University of Washington, 4245 Roosevelt Way NE, Box 354755, Seattle, WA, 98105, USA,

The overwhelming majority of glenohumeral dislocations are anterior dislocations that either spontaneously reduce or are reduced at the point of care without significant complications. Posterior dislocations are uncommon, and superior and inferior dislocations are even rarer. We present a case of "superolateral" shoulder dislocation in which the entire rotator cuff was torn either off its insertion or at the musculotendinous junction in combination with a large longitudinal split tear of the deltoid muscle. Read More

Orthop Nurs 2015 Jan-Feb;34(1):51-3

Andrea Emilio Salvi, MD, Orthopaedics and Traumatology Department, Mellino Mellini Hospital Trust, Civil Hospital of Chiari (Brescia), Italy. Simone Roda, PNA, A.O.D. Hospital Trust, Civil Hospital of Desenzano del Garda (Brescia), Italy. Massimo Pezzoni, MD, Orthopaedics and Traumatology Department, Mellino Mellini Hospital Trust, Civil Hospital of Chiari (Brescia), Italy.

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 significant 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 reduced with uneventful recovery. Read More

Unfallchirurg 2014 Dec;117(12):1125-38; quiz 1138-40

Steadman Philippon Research Institute, Suite 1000, 81657, Vail, CO, USA.

Fractures of the anteroinferior glenoid rim, termed bony Bankart lesions, have been reported to occur in up to 22% of first time anterior shoulder dislocations. The primary goal of treatment is to create a stable glenohumeral joint and a good shoulder function. Options for therapeutic intervention are largely dependent on the chronicity of the lesion, the activity level of the patient and postreduction fracture characteristics, such as the size, location and number of fracture fragments. Read More

Knee Surg Sports Traumatol Arthrosc 2016 Jun 23;24(6):1961-7. Epub 2014 Aug 23.

Wrightington Hospital, Wigan, UK.

Purpose: To compare outcomes of acromioclavicular (AC) joint reconstruction with ligament augmentation and reconstruction system (LARS) ligament in professional and non-professional athletes at 2-year minimum follow-up.

Methods: Forty-three patients (men; mean age 30, range 19-54 years) with Rockwood type III to V chronic AC joint dislocations underwent AC joint reconstruction with LARS ligament and standardized rehabilitation. Patients were divided into two groups: professionals (22) and non-professionals (21). Read More