Types of Anterior Dislocation


- See: Multidirectional Instability

- Radiographic Subtypes:
    - Subcoracoid

         - most common type of anterior dislocation
         - head of humerus is displaced anteriorly w/ respect to glenoid, & is inferior to coracoid process;
         - greater tuberosity is fixed on anterior glenoid rim;
         - neck of scapula is elevated and carried medially, positioning inferior tip of scapula in an abducted position;
    - Subglenoid:
         - occurs in about 1/3 patients w/ anterior dislocation;
         - head of the humerus lies anterior and below the glenoid fossa;
         - the majority of these fractures are associated w/ either a greater tuberosity fracture or a fracture of the anteiror inferior glenoid rim;
    - Subclavicular
         - head of the humerus lies medial to the coracoid process, just inferior to the lower border of the clavicle;
    - Inferior dislocation of the glenohumeral joint: luxatio erecta
         - humeral head lies inferior to glenoid fossa;
         - superior aspect of articular surface of humeral head is directed inferiorly and is not in contact with the inferior glenoid rim;
         - severe soft tissue injuries or fractures about the proximal humerus occur with this dislocation;
         - look for avulsion of the supraspinatus, pectoralis major, or teres minor muscles and fractures of the greater tuberosity

- Arthroscopic Findings:
         - ALPSA lesion
                    - Neviaser’s Contribution to the Treatment of ALPSA lesions 
                    - Anterior labroligamentous periosteal avulsion lesions may be associated with higher rate of recurrent dislocations than Bankart lesions following arthroscopic capsulolabral repair
         - glad lesion
         - perthes lesion
                    - scapular periosteum remains intact but is stripped medially 
                    - reference:
                          - Which labral lesion can be best reduced with external rotation of the shoulder after a first-time traumatic anterior shoulder dislocation? 


 

Year Book: [Erect Dislocation of the Shoulder (Luxatio Erecta Humeri):  General Review of 10 Cases.]

Luxatio erecta: the inferior glenohumeral dislocation.

Brachial plexus injury with erect dislocation of the shoulder.

The two-step maneuver for closed reduction of inferior glenohumeral dislocation (luxatio erecta to anterior dislocation to reduction).




Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Monday, June 25, 2012 4:34 pm