Wednesday, March 9, 2016

Subluxation, "You keep using that word. I do not think it means what you think it means"

Most of us recall this movie segment in which the Sicilian Vizzini keeps using the word “inconceivable" to refer to events unfolding while Inigo Montoya says “You keep using that word, I do not think it means what you think it means”.


Some authors use the term 'subluxation' to refer to the position of the humeral head in relation to the body of the scapula, whereas subluxation actually means separation of the joint surfaces as in incomplete or partial dislocation of the joint.

The difference is nicely demonstrated on an axillary x-ray of a patient with glenoid dysplasia. One can see that the humeral head center (blue dot) lies well posterior to the plane of the scapula (red line), but is quite well centered (not subluxated) on the retroverted face of the glenoid (the blue line was constructed perpendicular to the center of the face of the glenoid socket).



Our view is that it is the glenohumeral and not the scapulohumeral relationship that is key: a goal of reconstructive surgery is to keep the humeral ball centered in the glenoid socket.


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