抄録
(Purpose)Luxatio erecta of the shoulder is a rare type of glenohumeral dislocation. We wish to report on 14 cases and discuss the mechanism of the injury according to the roentogenographic findings and associated injuries.
(Patients and methods) We evaluated 14 patients with luxatio erecta of the shoulder,8 females and 6males whose ages ranged from 17 to 88 years(average,64.3 years). Eight patients fell down with their arms hyperabducted overhead. Three patients were injured in motor vehicle accidents and the mechanisms of the injury were unknow. Tow patients were injured by direct force applied to the shoulder from above when their shoulder was elevated. One patient was dislocated while playing volleyball. Twelve of the 14 cases had complications; fractures of the proximal humerus(2 cases), an axillary nerve injury(1 case), recurrent dislocations(3 cases), and chronic massive rotator cuff tears(8 cases). Closed reduction of the dislocation succeeded in each case. Tension band wiring was performed in two cases with associated fractures. Twelve cases were treated conservatively.
(Results)The patients were divided into 2 types of mechanisms of dislocation. Type 1(7 cases): the humeral head in fixed to the anteroinferior glenoid rim without a tear of the inferior capsule. Type 2(7cases): the humeral head is lying inferior to the glenoid fossa with a tear of the inferior capsule and a chronic massive rotator cuff tear. The average JOA scores were 90.0 points in type 1 and 89.7 points in type 2.
(Conclusion)Violent force is not always necessary to produce luxatio erecta of the shoulder. The position of the arm in a large measure influences its occurrence. Especially, in cases with a chronic massive rotator cuff tear, luxatio erecta of the shoulder can be produced by a mild force.
