scholarly journals A Proximal Humerus Fracture Dislocation in a Patient with Stiff Person Syndrome

2019 ◽  
Vol 2 (1-3) ◽  
pp. 28-32
Author(s):  
Connor W. Sullivan ◽  
Khusboo Desai ◽  
Abdul R. Arain ◽  
R. Maxwell Alley
Keyword(s):  
Medical Management ◽  
Proximal Humerus Fracture ◽  
Proximal Humerus ◽  
Surgical Intervention ◽  
Recurrent Dislocation ◽  
Humerus Fracture ◽  
Fracture Dislocation ◽  
Stiff Person Syndrome ◽  
Shoulder Hemiarthroplasty ◽  
Subsequent Revision

We present a case of a 47-year-old female who presented with an atraumatic posterior proximal humerus fracture dislocation secondary to episodic spasms, later diagnosed to be caused by stiff person syndrome (SPS). She underwent a shoulder hemiarthroplasty as well as a subsequent revision for recurrent dislocation and instability. SPS is a challenging diagnosis and we recommend optimization of medical management prior to surgical intervention.

scholarly journals SEVER INFERIOR HUMERAL HEAD SUBLUXATION FOR 3 MONTHS IN PROXIMAL HUMERUS FRACTURE DISLOCATION

2021 ◽  
Vol 9 (08) ◽  
pp. 870-873
Author(s):  
Emad M. Allehyani ◽  
Ahmed K. Alsarhani ◽  
Ahmed Alsyed
Keyword(s):  
Humeral Head ◽  
Proximal Humerus Fracture ◽  
Proximal Humerus ◽  
Axillary Nerve ◽  
Fracture Pattern ◽  
Humerus Fracture ◽  
Fracture Dislocation ◽  
Medical Illness ◽  
Patient Factors

Proximal humerus fracture is common fracture 4-6% of all fractures (1), third most common non vertebral fracture in elderly >65 years (2), affecting female more than males in ratios of 2:1.Approximately half (51%) of these fractures are displaced, the majority of which involve the surgical neck (77%). (3) Surgical treatment (mainly internal fixation or humeral head replacement) is being increasingly used (4).Management of each fracture is dependent of patient factors, fracture pattern, and complexity.Case scenario:33 years old female not known to has any medical illness, presented to the emergency department with right shoulder pain and inability to move it after motor cycle accident. X-rayshowed proximal humerusfracture dislocation Upon Post-operative follow up patient developed sever inferior humeral head subluxation, With intact axillary nerve sensation and motor exam.Discussion:proximal humerus fracture is common, fracture pattern and type, with patient factors will guide your management.proximal humerus fracture dislocation is more difficult and challenging to surgeon in managing such fracture, with inferior hemeral head subluxation is common can reach to 42% in the radiographic incidence among proximal humerus fracture.

Anterior proximal humerus fracture dislocation with concomitant glenoid fracture: An operative challenge! A case report

Trauma ◽  
2021 ◽  
pp. 146040862110195
Author(s):  
Dheeraj Attarde ◽  
Atul Patil ◽  
Nilesh Kamat ◽  
Parag Sancheti ◽  
Ashok Shyam
Keyword(s):  
Case Report ◽  
Proximal Humerus Fracture ◽  
Proximal Humerus ◽  
Alternative Pathway ◽  
Humerus Fracture ◽  
Fracture Dislocation ◽  
Anterior Dislocation ◽  
Bony Union ◽  
Glenoid Fracture ◽  
Deltopectoral Approach

Introduction Combined proximal humerus fracture dislocation and glenoid fracture is a rare combination of injuries which presents technical operative challenges. There is little evidence to guide surgical management. Case Report We report a case of a proximal humerus fracture with anterior dislocation and glenoid fracture treated in the same sitting with open reduction and internal fixation with angular stability locking plate and cannulated screw. The surgical technique involved standard deltopectoral approach with coracoid osteotomy. Conclusion By addressing both fractures operatively at the same time, we reported a satisfactory clinical and functional outcome with bony union of the fracture sites without instability at end of 1 year. Coracoid osteotomy may open an alternative pathway to treat complex proximal humerus injuries with ipsilateral glenoid fracture.

scholarly journals Shoulder Hemiarthroplasty for Proximal Humerus Fracture

2021 ◽  
Vol 35 (2) ◽  
pp. S3-S4
Author(s):  
Blake J. Schultz ◽  
Dylan T. Lowe ◽  
Kenneth A. Egol ◽  
Joseph D. Zuckerman
Keyword(s):  
Proximal Humerus Fracture ◽  
Proximal Humerus ◽  
Humerus Fracture ◽  
Shoulder Hemiarthroplasty

Cases of Missed Posterior Fracture-Dislocation of the Shoulder

2020 ◽  
Author(s):  
Morteza Nakhaei Amroodi ◽  
Farzad Amouzadeh Omrani ◽  
Naser Ghanbari ◽  
Melika Alaedini
Keyword(s):  
Young Adults ◽  
Proximal Humerus Fracture ◽  
Proximal Humerus ◽  
Rare Condition ◽  
High Energy ◽  
Posterior Dislocation ◽  
Humerus Fracture ◽  
Fracture Dislocation ◽  
High Energy Trauma ◽  
X Ray

Proximal humerus fracture-dislocation is a rare condition that occurs mostly in young adults due to high energy trauma and about 60-79 percent of misdiagnosis is occurred in the first diagnosis. In this article, we present two patients with proximal humerus fracture-posterior dislocation the fractures of whom were diagnosed, but after the radiographic studies including x-ray and computer tomography (CT) scan, the posterior dislocation was misdiagnosed. In addition, complications, management, and avoidance of this misdiagnosis were discussed.

scholarly journals Fracture Dislocation of Shoulder

2014 ◽  
Vol 3 (2) ◽  
pp. 44-45
Author(s):  
Hemanta Kumar Manandhar ◽  
Pramod Devkota ◽  
Padam Bahadur Khadka ◽  
Chakra Raj Randey
Keyword(s):  
Internal Fixation ◽  
Range Of Motion ◽  
Shoulder Dislocation ◽  
Open Reduction ◽  
Proximal Humerus Fracture ◽  
Proximal Humerus ◽  
Humerus Fracture ◽  
Fracture Dislocation ◽  
Good Range

Simultaneous dislocation of shoulder with fracture of the ipsilateral humerus is extremely rare and very little reported in the literature. We report a case of forty three year old man who got right shoulder dislocation with proximal humerus fracture. The patient was treated with open reduction and internal fixation by three 4.5mm screws. The operation went uneventful and has good range of motion of the shoulder after six months of follow up. DOI: http://dx.doi.org/10.3126/noaj.v3i2.9529   NOAJ July-December 2013, Vol 3, Issue 2, 44-45

scholarly journals Primary Hemiarthroplasty Following Severe Proximal Humerus Fracture Dislocations with Irretrievable Humeral Head in Young Patients

2017 ◽  
Vol 16 (1) ◽  
Author(s):  
Lim Chia Hua ◽  
Khairul Nizam Siron
Keyword(s):  
Humeral Head ◽  
Proximal Humerus Fracture ◽  
Proximal Humerus ◽  
Young Patients ◽  
Humerus Fracture ◽  
Fracture Dislocation ◽  
Proximal Humerus Fractures ◽  
Range Of Movement ◽  
Humerus Fractures ◽  
Good Range

Neer first popularised the use of primary hemiarthroplasty to treat complex proximal humerus fractures, especially when the humeral head is nonviable or not reconstructable with internal fixations, and with younger patients. A 16-year-old boy had a motor vehicle accident and sustained a closed right proximal humerus fracture dislocation without neurovascular injury. Intraoperatively, due to difficulty retrieving the humeral head which dislocated and positioned behind the clavicle, hemiarthroplasty was done to avoid injuring the brachial plexus, vessels and lung. Mr Y, a 34-year-old man similarly sustained closed left proximal humerus fracture dislocation with an irretrievable head. He too underwent hemiarthroplasty. Both patients were followed up for a year with no pain and fairly good range of movement and muscle power. In complex proximal humerus fractures, there is still debate regarding primary hemiarthroplasty. There are risks of secondary displacement of fracture fragments and head necrosis after internal fixation. Neer and Cofield reported over 90% patients had relief of pain and 66% patients had free range of movement post hemiarthroplasty. Other authors described primary malposition and subsequent migration or deficient osseous integration as a complication after prosthesis. In a thirteen-year observational cohort study of 163 patients with hemiarthroplasty, the overall rate of prosthetic survival was 96.9% at one year, 95.3% at five years, and 93.9% at ten years. Of the factors that were assessed, the age is most important due to factors such as degenerative changes in the rotator cuff, osteoporosis, and motivation to achieve a good range of motion. Successful treatment of acute proximal humerus fractures with prosthetic replacement is challenging to orthopaedic surgeons as it requires proper patient evaluation, good surgical technique, especially in soft-tissue tensioning and stability, and meticulous rehabilitation. In young patients with good bone quality and irretrievable head, hemiarthroplasty is a choice.

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