J Korean Fract Soc.  2019 Jan;32(1):47-51. 10.12671/jkfs.2019.32.1.47.

Shoulder Quadruple Dislocation Fracture: Fracture of Glenoid Rim, Coracoid Process, Greater Tuberosity, Surgical Neck of Humerus Associated with Anterior Shoulder Dislocation: A Case Report

Affiliations
  • 1Department of Orthopaedic Surgery, Dankook University College of Medicine, Cheonan, Korea. ssjb1990@dku.edu

Abstract

Shoulder joint dislocation has the most common incidence rate compare compared to other joints. It is reported that shoulder Shoulder dislocation couldmay be associated with glenoid rim, greater tuberosity of humerus and coracoid process fracture. There were have only been 2 cases of anterior shoulder dislocation simultaneously combined with simultaneous glenoid rim, coracoid process, and humerus greater tuberosity fracture worldwide and no report reports in Korea. We present a case of quadruple fracture (glenoid rim, coracoid process, greater tuberosity, surgical neck of humerus) associated with anterior shoulder dislocation and treated successfully by open reduction. In addition, with we provide the injury mechanism, diagnosis, treatment procedure and discussion.

Keyword

Shoulder; Dislocation; Fracutre

MeSH Terms

Diagnosis
Dislocations*
Humerus*
Incidence
Joints
Korea
Neck*
Shoulder Dislocation*
Shoulder Joint
Shoulder*

Figure

  • Fig. 1 Shoulder plain radiographs anteroposterior (A) (arrow: displaced surgical neck fracture, arrowhead: displaced tuberosity fragment), lateral (B) demonstrate anterior shoulder dislocation with glenoid rim, coracoid process, greater tuberosity of humerus, and surgical neck fracture.

  • Fig. 2 Three-dimentional reconstruction of shoulder computed tomographies shows 3-part proximal humerus fracture (arrow: displaced surgical neck fracture, arrowhead: displaced tuberosity fragment).

  • Fig. 3 Glenoid fracture (A) was shown and glenoid bone defect (B) was evaluated based on 3-dimentional reconstruction of shoulder computed tomography (arrow: percentage of glenoid defect).

  • Fig. 4 Immediate postoperative plain radiographs anteroposterior (A), axial (B) view were assessed.

  • Fig. 5 Plain radiographs anteroposterior (A), lateral (B) 3 months after initial surgery show bony union around proximal shoulder, but malunion of the coracoid process.


Reference

1. Liavaag S, Svenningsen S, Reikerås O, et al. The epidemiology of shoulder dislocations in Oslo. Scand J Med Sci Sports. 2011; 21:e334–e340.
Article
2. Antonio GE, Griffith JF, Yu AB, Yung PS, Chan KM, Ahuja AT. First-time shoulder dislocation: high prevalence of labral injury and age-related differences revealed by MR arthrography. J Magn Reson Imaging. 2007; 26:983–991.
Article
3. Green A, Izzi J Jr. Isolated fractures of the greater tuberosity of the proximal humerus. J Shoulder Elbow Surg. 2003; 12:641–649.
Article
4. te Slaa RL, Verburg H, Marti RK. Fracture of the coracoid process, the greater tuberosity, and the glenoid rim after acute first-time anterior shoulder dislocation: a case report. J Shoulder Elbow Surg. 2001; 10:489–492.
Article
5. Plachel F, Schanda JE, Ortmaier R, Auffarth A, Resch H, Bogner R. The “triple dislocation fracture”: anterior shoulder dislocation with concomitant fracture of the glenoid rim, greater tuberosity and coracoid process-a series of six cases. J Shoulder Elbow Surg. 2017; 26:e278–e285.
Article
6. Baudi P, Righi P, Bolognesi D, et al. How to identify and calculate glenoid bone deficit. Chir Organi Mov. 2005; 90:145–152.
7. Scheibel M, Kraus N, Gerhardt C, Haas NP. Anterior glenoid rim defects of the shoulder. Orthopade. 2009; 38:41–48. 50–53.
8. Ogawa K, Yoshida A, Takahashi M, Ui M. Fractures of the coracoid process. J Bone Joint Surg Br. 1997; 79:17–19.
Article
9. Rowe CR, Patel D, Southmayd WW. The Bankart procedure: a long-term end-result study. J Bone Joint Surg Am. 1978; 60:1–16.
10. Goodier D, Maffulli N, Good CJ. Coracoid process and greater tuberosity fracture in unreduced shoulder dislocation. Injury. 1994; 25:113–116.
Article
11. Bassett RW, Browne AO, Morrey BF, An KN. Glenohumeral muscle force and moment mechanics in a position of shoulder instability. J Biomech. 1990; 23:405–415.
Article
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