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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).