Utility of interscalene brachial plexus block with postural modification for inferior shoulder dislocation with fracture: a case report.

BACKGROUND: Inferior shoulder dislocation (luxation erecta) is a rare condition, accounting for approximately 0.5% of all shoulder dislocations, typically resulting from high-energy trauma, such as falls or motor vehicle accidents. CASE PRESENTATION: This case involved a man in his late 50s who sustained an inferior left shoulder dislocation with a greater tuberosity fracture after falling 2 m during work-related activities. Due to the patient's elevated BMI and absence of an anesthesiologist, general anesthesia was not feasible and local anesthesia led to inadequate pain relief and complicated reduction. We employed an interscalene brachial plexus block, enhanced by a modified approach involving positional adjustment and elastic taping, to address the abducted arm position and potential cervical spine concerns. Reduction was successfully performed without complications, such as neurovascular injury and respiratory issues. CONCLUSIONS: This report describes a modified interscalene block technique that may serve as a practical alternative in selected cases where general anesthesia is unavailable.