Successful closed reduction for iatrogenic displacement of the anatomical neck of the humerus: a case report

BACKGROUND: We report a rare case in which closed reduction was successfully obtained for iatrogenically displaced fracture-dislocation of the humeral anatomical neck with a favorable clinical outcome. CASE PRESENTATION: A 53-year old postman suffered from shoulder dislocation with an undisplaced fracture of the humeral anatomical neck which was initially undiagnosed. After the first attempt to reduce the dislocation of the shoulder joint by Stimson’s method, complete displacement of the fractured humeral anatomical neck occurred. By closed reduction under general anesthesia, the displaced humeral head was successfully reduced and was subsequently treated by conservative therapy using sling immobilization. Follow-up by MRI two years later showed no evidence of avascular necrosis of the humeral head. The patient showed a satisfactory range of motion of the affected shoulder joint. In the present case, the blood supply was partially preserved because a part of the lesser tubercle remained attached to the displaced humeral head. CONCLUSION: Based on this experience, we concluded that closed reduction might be attempted before deciding to perform an open reduction and internal fixation for displaced fracture-dislocation of the humeral anatomical neck.