Severe Thoracic Trauma Due to an Intrathoracic Dislocation of a Fractured Humeral Head in an Aged Patient; A Case Report

Holger Rupprecht, Marius Ghidau, Katharina Gaab

Abstract

Fracture and intrathoracic dislocation of the humeral head are extremely rare and often the result of a severe trauma. We herein report a case of humeral head fracture and dislocation with displacement into the chest cavity. A 75-year-old man fell down the stairs at home, landing on the right half of his body. Clinical impressive was a massive skin emphysema on the right hemithorax. A chest x-ray was performed. Conspicuous was a dubious opacity in the right subfield of the lung. The following CT-scan showed an additional fracture of the right scapula, a lung contusion and as “corpus delicti” a right intrathoracic dislocated humeral head fracture. The current case is extremely rare pattern of injury and the surgical emergency management is discussed. In most patients, a thoracotomy, which is related to a higher lethality and higher morbidity, can be avoided, if after stabilization a video assisted thoracoscopy is performed for revision of the pleural cavity and extraction of the humeral head.

Keywords

Humeral head fracture; Intrathoracic dislocation; Thoracic trauma; Video assisted thoracoscopy; Shoulder endoprosthesis; Multiple rib fractures.

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