Irreducible inferior shoulder dislocation requiring open reduction: A case report

Area of Science:

• Orthopedic Surgery
• Trauma Care

Background:

• Inferior shoulder dislocation (ISD) is uncommon.
• Closed reduction is typically successful for ISD.
• Irreducible ISD requiring open reduction is exceptionally rare.

Observation:

• A 90-year-old woman presented with right ISD and greater tuberosity avulsion fracture after a fall.
• Closed reduction under general anesthesia was unsuccessful.
• Open reduction revealed humeral head entrapment by the inferior shoulder capsule.

Findings:

• The irreducible nature of the ISD was attributed to humeral head entrapment by the inferior capsule.
• Associated greater tuberosity fracture and rotator cuff tear (RCT) contributed to the irreducibility.
• Post-reduction, inferior instability persisted, requiring fixation of the fracture and repair of the RCT.

Implications:

• This case underscores the complex biomechanics involved in irreducible ISD.
• Prompt surgical intervention, including open reduction and repair of associated injuries, is crucial.
• Preoperative planning for potential fixation of greater tuberosity fractures and rotator cuff repair is recommended in cases of ISD with these concomitant injuries.