Shoulder Case 12 History/Physical Exam

The typical history will be fall onto the affected side with the arm elevated (abducted). This causes hyperabduction, resulting in the inferior dislocation. The pectoralis major muscle pulls the humerus into the erect position, while the teres major and latissimus dorsi pull the humeral head inferiorly. 

Classically the patient presents with the arm fixed in an abducted position, frequently rested on top of or behind their head with the shoulder in 70°–170°degrees of abduction. The humeral head can possibly be palpated in the patient’s axilla.

Due to the association of luxatio erecta with neurovascular injuries, a detailed neurovascular exam must be performed upon initial evaluation and after any subsequent interventions.