JBJS | Article

The Journal of Bone & Joint Surgery, Volume 87, Issue 9

Case Reports | September 01, 2005

Upper-Extremity Deep-Vein Thrombosis After Anterior Shoulder Dislocation and Closed Reduction: A Case Report

Andrew A. Willis, MD¹; Nikhil N. Verma, MD²; Steven J. Thornton, MD¹; Nicholas J. Morrissey, MD¹; Russell F. Warren, MD¹

¹ Division of Sports Medicine and Shoulder Surgery (A.A.W., S.J.T., and R.F.W.) and Division of Vascular Surgery (N.J.M.), New York Presbyterian Medical Center, Weill Medical College of Cornell University, 535 East 70th Street, New York, NY 10021.
² Department of Orthopedic Surgery, Rush University Medical Center, 1725 West Harrison Street, Chicago, IL 60612. E-mail address: nikhilverma@hotmail.com

The Journal of Bone & Joint Surgery. 2005; 87:2086-2090 doi:10.2106/JBJS.D.02135

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Extract

The shoulder is one of the most commonly dislocated joints in the body, accounting for nearly 45% of all dislocations1. Approximately 85% of glenohumeral dislocations are anterior, and they are typically the result of an acute traumatic event. Typically, these injuries involve disruption of the anterior aspect of the glenoid labrum, joint capsule, or rotator cuff tendons; associated fracture of the glenoid rim or proximal part of the humerus is not uncommon2. Neurovascular injury is infrequent, and few studies have addressed associated venous complications.

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Topics

deep vein thrombosis ; thrombosis ; arm ; shoulder dislocations, anterior

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These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.

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Rachala Madhu

Posted on September 16, 2005

Clinical Risk Assessment

John Radcliffe Hospital , Oxford, UK

To The Editor:

The case report by Willis et al raises the following questions:

1) The authors state that multiple attempts to achieve closed reduction were performed by staff room physician with the patient under conscious sedation. How many such attempts were done? Would it not have been ideal to attempt reduction under GA/ Regional Anaesthesia in the operating room after two failed reductions in emergency room?

Multiple failed attempts to reduce a dislocated shoulder using a traction-countertraction technique can cause more repetitive soft tissue trauma than the initial single traumatic event and this trauma may be related to the complication of upper extremity DVT.

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