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Case Reports
. 2010 Jul;4(3):83-5.
doi: 10.4103/0973-6042.76970.

Irreducible anterior and posterior dislocation of the shoulder due to incarceration of the biceps tendon

Michael S Day  1 , David M Epstein, Brett H Young, Laith M Jazrawi
Affiliations
Case Reports

Irreducible anterior and posterior dislocation of the shoulder due to incarceration of the biceps tendon

Michael S Day et al. Int J Shoulder Surg. 2010 Jul.

Abstract

Mechanical obstacles may infrequently impede closed reduction of anterior shoulder dislocation. Imaging techniques such as arthrography, computed tomography (CT) and magnetic resonance imaging (MRI) complement conventional radiography by allowing identification of obstacles to reduction. We present a case of irreducible anterior glenohumeral dislocation resulting from an initial anterior dislocation, converted to a posterior dislocation with an attempt at reduction, then converted back to anterior dislocation with a second reduction attempt. Soft tissue obstacles to shoulder reduction should be suspected when plain films do not identify a bony fragment as the culprit. CT and MRI are useful for identifying the cause of irreducibility and for operative planning.

Keywords: Biceps tendon; computed tomography; irreducible; shoulder dislocation.

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Conflict of interest statement

Conflict of Interest: None declared

Figures

Figure 1
Figure 1
Scapular Y views of (a) anterior and (b) posterior dislocation of the left shoulder
Figure 2
Figure 2
Oblique coronal 2D reconstructions demonstrate the long head of biceps tendon (white arrows) dislocated lateral and posterior to the humeral neck and head. Note a Hill–Sachs defect (curved arrow) (c: coracoid; g: glenoid)
Figure 3
Figure 3
CT images obtained with axial 3 mm collimation demonstrate the long head of biceps tendon dislocated lateral to the (a) proximal humeral shaft and (b) bicipital groove as well as (c) posterior to the greater tuberosity and (d) Hill–Sachs defect. Note failed closed shoulder reduction with anterior subcoracoid dislocation of the humeral head
Figure 4
Figure 4
Intraoperative photo of long head of the biceps tendon (L) preventing reduction of the humerus (H) (arrow: glenoid)
See this image and copyright information in PMC

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