Intrathoracic fracture-dislocation of the humeral head: A case report and review of the literature

Background: Intrathoracic displacement of a humeral head fracture is extremely rare. Only slightly more than 30 cases have been reported in this regard. Since few reported, there no consensus on how to treat injury. The etiology, injury mechanism, related lesions, and treatment the are diverse. Case presentation: A 73-year-old female presented with multiple fractures left ribs, bilateral lung contusions, extensive emphysema anterior posterior chest wall, massive hemopneumothorax, fracture-dislocation proximal humerus, intrathoracic head. patient was sent operating room for emergency thoracotomy surgery. humerus confirmed be completely removed from thoracic cavity during operation. After discussion orthopedic surgeon, discarded considering avascular necrosis; moreover, open reduction internal fixation were not performed. surgery team performed reverse shoulder arthroplasty three weeks later. During follow-up, patient’s free pain, its range movement included 110° flexion, 70° abduction, 35° external rotation, 50° rotation. Conclusion: due very rare serious trauma that requires multidisciplinary treatment. Considering high risk necrosis, actively removing broken bone fragments early stage recommended, we advocate elderly patients. Detailed preoperative evaluations individualized operation plans should made achieve best effect.