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Updated: Jan 5, 2026
Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
[Suspected traumatic posterior shoulder luxation]
Mark H F Keulen1,2, Stijn G C J de Joode1, Steffie E J M Klemann-Harings1
1Zuyderland Medisch Centrum, afd. Orthopedie, Heerlen.
Insights
Obstetric brachial plexus lesions can lead to shoulder deformities. Posterior shoulder luxation is a rare complication requiring specialized multidisciplinary care, as closed reduction is ineffective.
Area of Science:
- Orthopedics
- Neurology
- Pediatric Medicine
Background:
- Obstetric brachial plexus lesions result from birth trauma during shoulder dystocia.
- Persistent lesions can cause secondary rotator cuff imbalance and glenohumeral deformities.
- This case highlights a rare complication in an adult with a history of such a lesion.
Observation:
- A 34-year-old male presented with acute right shoulder pain.
- Initial X-rays suggested posterior shoulder luxation, but closed reduction attempts failed.
- CT scan revealed severe glenohumeral dysplasia with posterior humeral head luxation and retroversion.
Findings:
- The patient experienced symptom relief with conservative management including rest and NSAIDs.
- Closed reduction was ineffective for the posterior shoulder luxation.
- Severe dysplasia and malrotation of the humeral head were identified as underlying issues.
Implications:
- Posterior shoulder luxation is a potential, albeit rare, complication of obstetric brachial plexus lesions.
- Standard closed reduction techniques are unsuitable for these complex cases.
- Multidisciplinary team expertise is crucial for optimal management of obstetric brachial plexus lesion complications.
Abstract:
BACKGROUND An obstetric brachial plexus lesion arises during childbirth as a consequence of excessive lateral traction of the neonate's head during shoulder dystocia. A small number of patients do not experience spontaneous recovery and secondary glenohumeral deformities can arise due to rotator cuff imbalance. CASE DESCRIPTION A 34-year-old man of Syrian descent with a history of a conservatively treated right-sided obstetric brachial plexus lesion went to the accident and emergency department (A and E) with acute pain in the right shoulder. Additional X-ray diagnostics suggested a posterior shoulder luxation, but attempts to relocate the glenohumeral joint in A and E failed. An additional CT scan of the shoulders revealed a severe right-sided dysplasia of the glenohumeral joint, with severe retroversion and posterior luxation of a rotated humeral head. After 3 weeks of relative rest through use of a sling and pain relief with an NSAID the pain had diminished and the patient had resumed his daily activities. CONCLUSION Posterior shoulder luxation can occur as a complication of obstetric brachial plexus lesion. Closed reduction is not of any use in these cases. The expertise of a specialized multidisciplinary team is indispensable for providing a patient with obstetric brachial plexus lesion with the best advice on treatment.
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