Epidemiology
Rare, inferior shoulder dislocation
Aetiology
Forced abduction injury
Pathology
Shoulder is hyperabducted
- humeral shaft abuts the acromion
- humeral head is levered inferiorly
- tears inferior capusle
Head becomes locked inferior to glenoid
May button hole through inferior capsule
- becomes irreducible
- need open reduction
Has tear rotator cuff / GT fracture
Associations
Tear RC
GT fracture
AXN palsy
Thrombosis axillary artery
Clinical Presentation
Patient has shoulder abducted
- has elbow flexed
- elbow resting on head
Reduction
Conscious sedation
- increased abduction initially
- then adduct
Post Reduction
MRI
- assess RC / biceps
AXN
- usually recovers