injuries poisoning
Shoulder Dislocations
Inferior Shoulder Dislocations
Inferior dislocations (luxatio erecta) are rare and usually clinically obvious; patients hold their arm over their head (ie, abducted to almost 180°), usually with the forearm resting on the head. The arm is shortened; the humeral head is often palpable in the axilla. The joint capsule is disrupted, and the rotator cuff may be torn. The brachial artery is injured in<5% of cases. The axillary nerve or another nerve is usually damaged, but deficits often resolve after reduction. X-rays are diagnostic. Reduction is done using Traction-countertraction technique for reducing anterior shoulder dislocations of the abducted arm. Closed reduction is usually successful unless there is a buttonhole deformity (humeral head is trapped in a tear of the inferior capsule); in such cases, open reduction is required. 