Ultrasound-guided interscalene block for the reduction of luxatio erecta in a high-risk patient: A case report

Alexandra Over, Tyler Nghiem, Pamela Santivanez, Amin Mohamadi, Josh Greenstein, Barry Hahn, William Caputo
{"title":"Ultrasound-guided interscalene block for the reduction of luxatio erecta in a high-risk patient: A case report","authors":"Alexandra Over,&nbsp;Tyler Nghiem,&nbsp;Pamela Santivanez,&nbsp;Amin Mohamadi,&nbsp;Josh Greenstein,&nbsp;Barry Hahn,&nbsp;William Caputo","doi":"10.1016/j.jemrpt.2025.100161","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Inferior glenohumeral dislocation (IGD), or luxatio erecta humeri, is a rare shoulder dislocation, accounting for 0.5 % of all cases. It often results from hyperabduction of the arm, causing the humeral head to dislocate inferiorly. IGD is associated with neurovascular complications, particularly in elderly patients with comorbidities. Traditional management involves procedural sedation, which may be risky in high-risk patients. Ultrasound-guided interscalene nerve blocks offer a safer alternative by providing localized pain control without sedation.</div></div><div><h3>Case report</h3><div>We report the case of an 85-year-old male with multiple comorbidities who presented with IGD after a fall. Given the patient's risks, an ultrasound-guided interscalene block was used for reduction. Reduction was achieved using the traction-countertraction method, confirmed by post-reduction radiographs. The patient experienced no immediate complications, and at follow-up, showed no signs of re-dislocation or neurological deficits.<strong>Why should an emergency physician be aware of this?</strong> Ultrasound-guided interscalene nerve blocks provide a safe and effective alternative to procedural sedation for IGD reduction, especially in high-risk patients. This approach minimizes opioid use, improves outcomes, and reduces emergency department resource utilization. Future guidelines should consider incorporating this technique for similar cases, with further studies needed to evaluate long-term outcomes.</div></div>","PeriodicalId":73546,"journal":{"name":"JEM reports","volume":"4 2","pages":"Article 100161"},"PeriodicalIF":0.0000,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"JEM reports","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2773232025000252","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

Abstract

Background

Inferior glenohumeral dislocation (IGD), or luxatio erecta humeri, is a rare shoulder dislocation, accounting for 0.5 % of all cases. It often results from hyperabduction of the arm, causing the humeral head to dislocate inferiorly. IGD is associated with neurovascular complications, particularly in elderly patients with comorbidities. Traditional management involves procedural sedation, which may be risky in high-risk patients. Ultrasound-guided interscalene nerve blocks offer a safer alternative by providing localized pain control without sedation.

Case report

We report the case of an 85-year-old male with multiple comorbidities who presented with IGD after a fall. Given the patient's risks, an ultrasound-guided interscalene block was used for reduction. Reduction was achieved using the traction-countertraction method, confirmed by post-reduction radiographs. The patient experienced no immediate complications, and at follow-up, showed no signs of re-dislocation or neurological deficits.Why should an emergency physician be aware of this? Ultrasound-guided interscalene nerve blocks provide a safe and effective alternative to procedural sedation for IGD reduction, especially in high-risk patients. This approach minimizes opioid use, improves outcomes, and reduces emergency department resource utilization. Future guidelines should consider incorporating this technique for similar cases, with further studies needed to evaluate long-term outcomes.
求助全文
约1分钟内获得全文 求助全文
来源期刊
JEM reports
JEM reports Emergency Medicine
自引率
0.00%
发文量
0
审稿时长
54 days
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信