Journal of Musculoskeletal Trauma

Original Articles

Inferior Subluxation of Humeral of Head after Surgery for Fracture of Proximal Humerus: Jun Gyu Moon, Hyok Woo Nam, Jong Oh Kim, Jong Kyoung Ha, Seok Bae Ryu; J Korean Fract Soc 2005;18(1):43-47. Published online January 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.1.43

PURPOSE
To study the development of inferior shoulder subluxation after surgery for proximal humerus fractures. To analyze the mechanism development of such subluxation and the association between different types of proximal humerus fractures, quality of reduction achieved the method of operation performed.
MATERIALS AND METHODS
A retrospective analysis of 45 proximal humerus fractures that were treated by surgery between March 1997 and July 2002 was done. All patients had a minimum of 12 months of postoperative follow up. Preoperative radiographs were classified by the Neer's classification. Different operative treatment methods, post reduction alignment and the degree of postoperative subluxation if present, were analysed. In order to evaluate effect of loss of negative intraarticular pressure, we compared this series with 15 cases of recurrent shoulder dislocation treated by open Bankart operation.
RESULTS
13 patients out of 45 (29%) developed immediate postoperative inferior shoulder subluxation. 3-part fractures of the proximal humerus showed a higher incidence of the same than the 2-part types. The better reduced fractures had lesser rates of subluxation. Open reduction (39%, 11 patients) results in an increased incidence of inferior subluxation than closed methods of reduction (13%, 2 patients).
CONCLUSION
Inferior subluxation of the humeral head after surgery for the proximal humerus fracture can occur and persist till postoperative period of 2 months. Deltoid muscle tone affected by shortening of humeral neck plays an important role. Early active exercise for restoration deltoid tone may be effective in prevention of inferior subluxation.

Citations

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Transient postoperative inferior subluxation of the shoulder after surgical stabilization of recurrent anterior dislocation in a patient with myasthenia gravis: a case report
Samuel Baek, Geum-Ho Lee, Myung Ho Shin, Tae Min Kim, Kyung-Soo Oh, Seok Won Chung
Clinics in Shoulder and Elbow.2023; 26(3): 302. CrossRef

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Inferior Subluxation of the Humeral Head After Trauma to the Shoulder: In Kim, Seung Koo Rhee, Yang Kim, Kee Haeng Lee; J Korean Soc Fract 1990;3(1):110-118. Published online May 31, 1990; DOI: https://doi.org/10.12671/jksf.1990.3.1.110

Abstract PDF: Since 1980, we have treated twelve patients who had antero-inferior subluxation of humeral head after acute trauma to the shoulder or to the proximal part of the humerus, of both. the diagnosis of subluxation was based on clinical and radiographic examination. To evaluate the rdiological features, and also to clarify the mechanism as well as the treatment for this subluxation, we have been analysed and the following results were obtained. 1. The careful radiographic interpretation, especially standing neutral shoulder AP and lateral films, was quite important to find the hidden soft tissue injuries which it could be caused the subluxation of humeral head after acute trauma to the shoulder. 2. The incidences of subluxation was 24.5%, 12 cases out of the total 49 cases. 3. The subluxation was frequently frequently developed in adduction type of fracture, avulsion fracture of the greater tuberosity and in women with over the 40 of their ages. 4. Intial subluxation of humeral head after trauma might be caused by the rupture of capsule of rotator cuff, and late subluxation may be developed by the loss of damaged muscle tone or direct muscle damage due to intial or sugical trauma. 5. Except the results of the nerve damage after trauma or surgery, the subluxation could be recovered by average 22 day after the first recognition of subluxation with hte vigorous isometric biceps setting exercise immediately after trauma. 6. Isometric biceps seetting exercise was the most important basic step for the every injuries aroud the shoulder joint.

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