A case that gives you a cold shoulder – bilateral posterior fracture dislocation of shoulder after electrical shock: A rare case report

Abstract

Introduction: Posterior dislocation of both shoulders is relatively rare and epileptic seizures has been considered as a common cause. Electrical injury is a rare cause of posterior shoulder dislocation. These cases are of special interest because most of them are missed on initial examination. Here we present a unique case of bilateral posterior dislocation of the shoulder with heterogeneous injury pattern- with one shoulder exhibiting reverse Hillsach’s lesion and the other isolated lesser tuberosity fracture. We will discuss mechanism of injury, investigative parameters and treatment protocols followed.Presentation of case: This report presents a case of bilateral posterior shoulder fracture dislocation after electrical shock. We were able to find a few individual case reports describing this condition. The case was acute and had a heterogeneous injury pattern of Reverse hill sach and Isolated lesser tuberosity fracture. Our treatment in this case consisted of closed reduction under general anesthesia of one shoulder and surgical reduction of other shoulder by McLaughlin procedure. Post operatively orthoses was used to keep the shoulders in abduction and external rotation. A rehabilitation program was begun after 3 weeks of immobilization. After 6 months of injury the patient has returned to work. 24 months postoperatively, at final follow-up, he was painless and capable of performing all of his daily activities.Discussion: The amount of bilateral shoulder dislocations after electrical injury with the following injury pattern is not reported but is known to be very rare. The aim of this case presentation is to report an example for this rare entity, highlight the difficulties in diagnosis and review the treatment options.Conclusion: Physical examination and radiographic evaluation are important for quick and accurate diagnosis. Early detection and treatment of such a condition is extremely important.