# A Woman with Right Shoulder Pain

## TL;DR

An 89-year-old woman with a rare shoulder dislocation and fracture was successfully treated through staged orthopedic procedures.

## Contribution

This case report presents a rare inferior shoulder dislocation with a concomitant humeral neck fracture and its management in an elderly patient.

## Key findings

- The patient had an inferior shoulder dislocation (luxatio erecta) with a humeral neck fracture.
- A staged reduction approach was used due to the patient's age and osteoporosis.
- Successful repair was achieved via arthroplasty within two weeks.

## Abstract

We report a case of an 89-year-old female who presented with pain in her right shoulder following a fall onto her outstretched hand. Upon presentation, her right hand was held behind her head and elbow held above her head in flexion. There was obvious deformity seen and felt in her axilla. Radiograph of the shoulder showed an inferior shoulder dislocation and impacted humeral neck fracture. Given her age and comorbid osteoporosis, a bedside reduction was performed by orthopedics where the humeral head was intentionally dislocated from the humeral shaft. Thirteen days after the initial shoulder dislocation, the patient’s shoulder was successfully repaired by open reduction.

Luxatio erecta, which means “erect dislocation” in Latin, refers to an inferior shoulder dislocation. It accounts for less than 1% of shoulder dislocations. Our case report highlights an inferior shoulder dislocation with a rare, concomitant humeral neck fracture, managed via staged reduction by orthopedics with intentional dislocation of the humeral head given concern over patient’s age and osteoporosis. The patient was eventually successfully repaired via arthroplasty within two weeks.