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Year : 2013  |  Volume : 47  |  Issue : 5  |  Page : 531-532
Author's reply

Department of Orthopedics and Trauma Center of Emergency Medicine, the First Affiliated Hospital,School of Medicine, Zhejiang University, Hangzhou, China

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Date of Web Publication17-Sep-2013

How to cite this article:
Wu JS, Du JY, Lin XJ. Author's reply. Indian J Orthop 2013;47:531-2

How to cite this URL:
Wu JS, Du JY, Lin XJ. Author's reply. Indian J Orthop [serial online] 2013 [cited 2020 Jan 24];47:531-2. Available from:

We are grateful to Cakmak et al. [1] who have shown interest in our manuscript. [2] We also read with great interest the letter to editor by Cakmak et al. [1] on the same issue After reviewing literature, we found that mechanisms of dislocation of the humeral head within the thorax are very complex, Harman et al. [3] defined the intrathoracic dislocation by the result from high energy trauma associated with abduction and external rotation, which then leads to an humeral head fracture and its confinement in the thorax; possibly similar to "Bottle Cap Opener Mechanism," Hardcastle et al. [4] in another case report on similar topic suggested that the posttraumatic transmission of the force along the humeral shaft, caused the dislocation of the humeral head within the thorax. However, a serious trauma related to hemodynamic instability may lead to accompanying life threatening conditions. Good medical examination and imaging to locate the humeral head fragment are crucial for making decisions on the treatment modality, thus, the patient should undergo a detailed systemic presurgical examination by experienced surgeons and strategies should be planned before the surgery.

   References Top

1.Cakmak S, Keklikci K, Sivrioglu AK, Rodop O. Intrathoracic displacement of the humeral head in a trauma patient. Indian J Orthop 2013;47:530-1.  Back to cited text no. 1
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2.Jun-Song W, Jing-Yu D, Zhi-Qiang W, Fang G, Xiang-Jin L. Intrathoracic displacement of the humeral head in a trauma patient. Indian J Orthop 2012;46:596-8.  Back to cited text no. 2
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3.Harman BD, Miller NG, Probe RA. Intrathoracic humeral head fracture-dislocation. J Orthop Trauma 2004;18:112-5.  Back to cited text no. 3
4.Hardcastle PH, Fisher TR. Intrathoracic displacement of the humeral head with fracture of the surgical neck. Injury 1981;12:313-5.  Back to cited text no. 4

Correspondence Address:
Xiang-Jin Lin
Department of Orthopedics, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310 003
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Source of Support: None, Conflict of Interest: None

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