Simultaneous bilateral anterior and posterior shoulder dislocations

Abstract

Shoulder dislocations, a common injury, are usually unilateral and secondary to trauma. In addition, 95% are anterior, and the remainder are posterior. Simultaneous bilateral anterior shoulder dislocations occur rarely.lm3 The cause of injury in these cases is almost always trauma. Honnefi reported 21 cases of bilateral posterior dislocations, of which 13 were sustained as a result of electroshock treatment, electrocution, or epilepsy. An unusual case is described of simultaneous bilateral shoulder dislocations in a 44-year-old man who awoke with one anterior and one posterior dislocation. The probable cause of this injury is also examined. CASE REPORT A 44-year-old man presented to the emergency department at 3:00 AM after being awakened from a sound sleep by severe bilateral shoulder pain. He had retired for the evening in his usual state of health and had been feeling well. He denied having fecal and urinary incontinence, tongue biting, or a history of seizure disorder. The past medical history showed a clinical diagnosis of mild arthritis in the right shoulder for which he took aspirin occasionally. The patient denied having had prior trauma or dislocation of either shoulder. He claimed alcohol consumption of two to three beers per day and admitted to occasional self-medication with 5 mg of diazepam during stressful situations. He denied any history of alcohol withdrawal in the past. The physical examination revealed an alert and oriented man in moderate distress with obvious lack of normal contour of both shoulders. Any movement of the upper extremities caused severe pain. Results of the neurological examination were normal. There was no evidence of external trauma.