A Rare Case of Intramediastinal Humeral Head Fracture Dislocation Through the Thoracic Inlet

Area of Science:

• Orthopedic Surgery
• Trauma Surgery
• Thoracic Surgery

Background:

• Intramediastinal humeral head fracture dislocation is an exceptionally rare injury resulting from blunt trauma.
• Such injuries may involve associated local and systemic complications due to high-energy mechanisms.
• Limited literature exists, with only one prior reported case, leaving treatment strategies undefined.

Purpose of the Study:

• To present a unique case of intramediastinal humeral head fracture dislocation.
• To discuss the diagnostic and management challenges associated with this rare condition.
• To contribute to the understanding of treatment modalities for this specific injury pattern.

Main Methods:

• A case study approach was used, detailing the clinical presentation, imaging, and treatment of a 71-year-old female patient.
• The patient sustained the injury after an accidental fall.
• Treatment involved three consecutive surgical interventions.

Main Results:

• The patient sustained an intramediastinal humeral head fracture dislocation through the thoracic inlet.
• The injury occurred without chest wall damage but involved a thoracic duct rupture.
• Three surgical procedures were necessary for management.

Conclusions:

• This case highlights the rarity and complexity of intramediastinal humeral head fracture dislocation.
• The management requires a multidisciplinary approach, often involving multiple surgical interventions.
• Further case reports are needed to establish optimal treatment guidelines for this uncommon injury.