An inferior shoulder dislocation is the least common form of shoulder dislocation. The condition is also called luxatio erecta because the arm appears to be permanently held upward, in fixed abduction. The patient will often present with their hand placed on the head or near it. This is known as "Salute" position.
Pathology
It is caused either of the following mechanisms:
- sudden forceful arm hyperabduction
- less commonly, direct loading force on fully abducted arm, with extended elbow and pronated forearm
The humeral head is forced against the acromion, usually with resultant inferior glenohumeral capsule rupture and rotator cuff disruption.
Radiographic features
The humeral head is displaced directly below and a bit medial to the glenoid fossa, with the arm often in marked abduction (luxatio erecta).
An inferior dislocation can mimic a subcategory of glenohumeral dislocation known as subglenoid anterior dislocation, where the humeral head rests directly inferior to the glenoid in the AP and lateral projections 4. It is distinguished from the latter by the humeral shaft's position parallel to the scapular spine.
TREATMENT
traction along the line of abduction followed by gradual adduction.
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