Luxatio Erecta

This is a case of a 49 year old construction worker who fell while working in a manhole. He presented with his shoulder in an abducted position which could not be reduced in the emegency room. A shoulder radiograph was obtained. The humeral head is dislocated completely inferiorly to the glenoid and is stuck in that position. The green arrow indicates the position of the glenoid. The red arrow demonstrates a comminuted distracted fracture of the greater tuberosity of the humerus. This dislocation usually cannot be spontaneously reduced and may require relocation under general anesthesia. This type of dislocation is rare. Far and away, the most common dislocation is an anterior dislocation. Posterior dislocation is rare and is usally seen in the setting of a seizure.