Often, there is a concern when inferior subluxation is seen after a proximal humerus fracture. This case below illustrates the problem and how it can be addressed. Most of the time no surgery is required for the "subluxation" as it is not clear what the cause of his phenomenon is. Could be intra-articular blood collection, or hemarthrosis. Could be associated with axillary n neuropraxia which relaxes the deltoid and leads to inferior displacement of the humerus. If no nerve damage and no dislocation is diagnosed, treatment should be in a sling or ORIF depending on other factors and not on subluxation. No surgery for the subluxation is required.
Inferior subluxation
Axillary view shows no dislocation
Position of the humeral head after application of sling
4 weeks post injury the fracture is healed and forward active elevation was to 110 degrees
No dislocation on scapular Y X-ray
3 months post injury the subluxation is resolved and the fracture is healed
