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Journal of the Korean Shoulder and Elbow Society 1998;1(2):167-174.
Published online November 30, 1998.
Transient Inferior Subluxation of the Shoulder
Suk-Kee Tae, M.D., Young Bok Jung, M.D., Keun-Hyung Park, M.D., Kwang-Sup Song, M.D.
Department of Orthopedic Surgery, Yongsan Hospital, Chung-Ang University
견관절의 일과성 하방 아탈구
태석기, 정영복, 박근형, 송광섭
중앙대학교 의과대학 정형외과학교실
Abstract
Since the first description by Cotton, there have been sporadic reports about the inferior subluxation of the shoulder. Nevertheless there is still a lack of consensus regarding the mechanism of occurrence, evolution and treatment. We have experienced six cases of inferior sublusation(five cases after trauma and one case after surgery) which resolved over time. Analysis of the clinical informations including serial radiographs, data from clinical examination and electromyography(EMG) revealed the following results. All the five post-traumatic inferior subluxations were noted in women with an average age of 59 years after direct trauma resulting in fracture of the proxiaml hrnerus(4) or clavicle(1), of which nerve injury was proven by EMG in three. One case occurred after Bankart repair by stretch injury to the axillary nerve. The presenting symptom was unusually severe pain on passive motion. Absence of anterior or posterior displacement wasl confirmed by radiographs. All the cases seemed to have delayed onset of subluxation except one. The subluxed hu.meral head was concentrically reduced at an average 11 weeks(range 3-23 weeks) from the supposed time of occurrence and the acromiohumeral interval measUred on the standing anteroposterior radiographs decreased to 9.4 mm ftom 23 mm. Improvement of pain paralled the reduction. In conclusion, the most common cause of transient inferior subluxation was nerve injury in ou~ series and the prognosis was excellent, however protraction of recovery or leaving permanent subluxation would be possible if .the injured nerve is unrecoverable.
Key Words: Shoulder; Subluxation; Inferior; Trauma; Surgery


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