Bilateral luxatio erecta: a case report.

BACKGROUND Luxatio erecta humeri or inferior dislocation of the glenohumeral joint is a rare presentation in the emergency department that is typically caused by a direct loading force on a fully abducted arm. This type of shoulder dislocation represents only 0.5% of all shoulder dislocations, making bilateral cases even more unique. OBJECTIVE The authors report a case of bilateral luxatio erecta to highlight some of the key clinical signs and discuss proper methods of care. CASE REPORT We report a case of bilateral luxatio erecta after a forward fall on a treadmill in a senior male patient. The patient grabbed onto the side rails of the treadmill such that his abducted arms received the entire force of the fall. These injuries were successfully reduced in the emergency department of our institution using a two-step approach for each: 1) conversion to anterior dislocation and 2) full reduction. CONCLUSIONS Although shoulder dislocations remain a commonly seen injury in the emergency department, it is important to consider that not all dislocations are simply anterior. Signature signs of luxatio erecta are fixed abduction at the shoulder with elbow flexion and forearm pronation. The humeral head should be palpable inferior to the glenoid fossa. The most effective treatments for this injury involve sufficient muscle relaxation for reduction, a methodical approach to reduction, and appropriate immobilization.