Abstract
Intrathoracic fracture-dislocation of the humeral neck is a rare and easily overlooked
clinical entity. We present a case and review of the literature. The objective of
this study was to summarize the clinical presentation of this injury and to provide
recommendations for initial diagnostic imaging and management. A 68-year-old man presented
to the Emergency Department after a fall onto an abducted arm with moderate respiratory
distress, mild left shoulder pain, and palpable crepitus over the shoulder and chest
wall. Radiographic examination demonstrated the humeral head to be lying within the
left hemithorax, devoid of any attachments to the remaining proximal humerus. After
initial stabilization, the patient underwent surgical excision of the humeral head
and delayed hemiarthroplasty. Careful attention to radiographic studies is required
to recognize this injury. Initial management centers on airway management, adjunctive
imaging, and treatment of any associated injuries followed by surgical excision and
proximal humeral reconstruction.
Keywords
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References
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- Intrathoracic dislocation of the humeral head.J Bone Joint Surg Am. 1961; 43: 428-430
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Article info
Publication history
Published online: July 24, 2008
Accepted:
September 4,
2007
Received in revised form:
August 28,
2007
Received:
May 16,
2007
Identification
Copyright
© 2010 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
