A neglected posterior fracture dislocation of the shoulder with ipsilateral distal humeral shaft fracture.

BACKGROUND: Cases of posterior dislocation or fracture-dislocation of the shoulder are rare. A combination of posterior dislocation and ipsilateral humeral shaft fracture, especially a distal third one, is even rarer. In such injuries, the diagnosis of shoulder dislocation may be missed because great attention is usually given to the fractured humerus.
OBJECTIVES: We present this case report to raise awareness among emergency physicians of this manner of injury. CASE REPORT: We present a case report of a 30-year-old woman who had posterior fracture dislocation of the right shoulder with ipsilateral distal humeral shaft fracture. The shaft fracture was initially evaluated, internally reduced, and fixed, whereas the posterior fracture-dislocation of the shoulder was not recognized. A belated diagnosis was established 1 month after the operation, when a computed tomography scan was performed because the patient reported continuous pain and limited range of motion of the shoulder. A second reduction was performed to reduce the dislocation. The patient had partial functional recovery 1 year later.
CONCLUSIONS: Consideration of this condition, coupled with thorough and appropriate physical and radiological examinations, could lead to improved recognition of such cases.