Bilateral, Asynchronous, Inferior Shoulder Dislocation in a Multidisabled Patient: A Case Report and Review of the Literature
Year: 2026
Type: article
Abstract: Introduction: Inferior glenohumeral dislocation, or luxatio erecta humeri (LEH), is an exceptionally rare injury accounting for approximately 0.5% of all shoulder dislocations. It typically results from high-energy trauma through hyperabduction or direct axial loading, forcing the humeral head inferiorly and locking the arm in abduction. While unilateral presentation is rare, bilateral occurrence is extraordinary. Diagnostic or therapeutic delays can cause severe, permanent neurovascular and musculoskeletal sequelae. Case Report: A 42-year-old male with profound neurodevelopmental disabilities - including cerebral palsy, intellectual disability, total blindness, and epilepsy - residing in a long-term care facility presented with an acute right LEH. Attempted closed reduction at an orthopedic center was unsuccessful, and the patient was discharged against medical advice without definitive intervention. Four years later, at age 46, the patient presented with a neglected, chronic left LEH. Due to the chronic, fixed nature of the bilateral injuries, the dislocations were deemed un-reducible, resulting in a profound and permanent accumulation of orthopedic disability. Conclusion: Managing LEH in patients with severe developmental disabilities presents unique diagnostic and therapeutic challenges. Cognitive and communication barriers often cause diagnostic overshadowing, leading to missed or severely delayed presentations. Furthermore, management is frequently complicated by patient uncooperativeness, high-risk anesthesia profiles, and increased risks of operative failure.
Authors: Fawzi E Ali, Yasmina F Ali
Institution: Gulf Medical University
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $250
OpenAlex ID: W7225586885
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