Ver el código de «Inferior shoulder dislocation»

==Background==
*Also known as "Luxatio Erecta" due to the presentation of arm held in full abduction
*Accounts for ~0.5% of all shoulder dislocations<ref name="Imerci" />
*MOI is typically hyperabduction force which levers the humeral neck against the acromion
**Can also be 2/2 high-energy force applied directly to shoulder from above<ref name="Grate">Grate I Jr. Luxatio erecta: a rarely seen, but often missed shoulder dislocation. Am J Emerg Med. 2000 May;18(3):317-21.</ref>
*Frequently associated w/ significant soft tissue injury or fracture<ref name="Imerci" />
**Axillary nerve palsy in 60% (usually rapidly resolves after reduction<ref name="Grate" />
**Humerus fracture in 37%
**Rotator cuff tear in 12%

==Clinical Features==
*Patient p/w humerus fully abducted with hand on or behind the head
*Humeral head can be palpated on axilla or lateral chest wall<ref name="Imerci">Imerci A, Gölcük Y, Uğur SG, et al. Inferior glenohumeral dislocation (luxatio erecta humeri): report of six cases and review of the literature. Ulus Travma Acil Cerrahi Derg. 2013 Jan;19(1):41-4.</ref>

==Differential Diagnosis==
{{Shoulder DDX}}

==Diagnosis==
*Plan film X-ray in at least 2 views

==Management==
*Closed reduction
**Consider [[Procedural sedation]]
**Apply traction in upward and outward direction (along same axis as humerus)
**Simultaneously apply counter-traction with sheet on upper shoulder and chest wall<ref>Amanda E. Horn and Jacob W. Ufberg. Management of Common Dislocations. http://clinicalgate.com/management-of-common-dislocations/</ref>
*Apply sling with arm in adduction and internal rotation.
*Post-reduction X-ray
[[File:luxatio erecta.jpg|thumbnail]]
*''Failure of closed reduction may occur 2/2 "buttonholing" of humeral through defect in glenohumeral capsule → consult ortho for open reduction''<ref>Lam AC, Shih RD. Luxatio Erecta Complicated By Anterior Shoulder Dislocation During Reduction. Western Journal of Emergency Medicine. 2010;11(1):28-30.</ref>

===Contraindications to closed reduction<ref name="Imerci" />===
*Humeral neck or shaft fracture
*Suspected major vascular injury
*In these cases, open reduction is indicated

==Disposition==
*Discharge after successful reduction
*Ortho follow-up

==See Also==
*[[Shoulder dislocation]]

==References==
<references/>

[[Category:Orthopedics]]
[[Category:Procedures]]