Author's reply.

Sir,

We are grateful to Cakmak et al.1 who have shown interest in our manuscript.2 We also read with great interest the letter to editor by Cakmak et al.1 on the same issue After reviewing literature, we found that mechanisms of dislocation of the humeral head within the thorax are very complex, Harman et al.3 defined the intrathoracic dislocation by the result from high energy trauma associated with abduction and external rotation, which then leads to an humeral head fracture and its confinement in the thorax; possibly similar to “Bottle Cap Opener Mechanism,” Hardcastle et al.4 in another case report on similar topic suggested that the posttraumatic transmission of the force along the humeral shaft, caused the dislocation of the humeral head within the thorax. However, a serious trauma related to hemodynamic instability may lead to accompanying life threatening conditions. Good medical examination and imaging to locate the humeral head fragment are crucial for making decisions on the treatment modality, thus, the patient should undergo a detailed systemic presurgical examination by experienced surgeons and strategies should be planned before the surgery.