Bilateral Posterior Dislocation Research Articles

Bilateral posterior shoulder dislocation secondary to seizure event

This case report presents a rare bilateral posterior shoulder dislocation resulting from a seizure. Bilateral shoulder dislocations are uncommon, especially in a posterior direction. Diagnosing and managing posterior shoulder dislocation can be challenging due to the need for specialized imaging techniques and expertise. This report details a 34-year-old male patient with a remote history of epilepsy without any fits or attacks over the past 16 years. Following a seizure, he sustained bilateral posterior shoulder dislocation and other associated fractures. The patient underwent reduction under general anesthesia and was immobilized using an arm sling. The outcome was favorable, with the patient improving during the follow-up period. Bilateral shoulder dislocation is a rare injury that can be missed in clinical practice and needs expertise in diagnosis and management. A low threshold of suspicion should be kept, especially in cases of seizure or electrical shock.

Bilateral posterior shoulder dislocation with associated reverse Hill-Sachs lesions after electrical injury

After workers suffer electric shock, the ankylosis and contraction of muscle groups around the shoulder joint are more likely to lead to posterior dislocation and fracture, of which 80% are complicated with reverse Hill-Sachs injury of humeral head. This paper reports a case of bilateral posterior dislocation of shoulder joint combined with Hill-Sachs injury caused by electric shock in the Department of Orthopedics, Affiliated Huzhou Hospital, Zhejiang University School of Medicine in August 2020. The diagnosis of left posterior shoulder dislocation was clear, and the diagnosis of right posterior shoulder dislocation was missed. The patient successfully reconstructed the stability of the shoulder joint by actively performing shoulder arthroscopic surgery to repair the joint capsule. After 6 months of follow-up, there was no further dislocation and the function was good.

Luxación Voluntaria de Hombro en el Niño. Reporte de Dos Casos

BackgroundVoluntary dislocation of the glenohumeral joint represents the ability to spontaneously dislocate a shoulder in one or more directions. The theoretical cause is the ability to contract agonist muscle groups, and inhibiting or relaxing antagonistic muscles, thus determining the direction of the dislocation. The diagnosis is usually made in childhood or adolescence when the patient demonstrates a voluntary shoulder dislocation. Historically, this condition has been linked to psychological disorders or illness and typically responds poorly to surgical interventions. Treatment typically consists of conservative management including cognitive behavioral therapy or physical therapy. Prior prospective studies have demonstrated no advantage to surgical interventions over nonoperative treatments, and in some cases with associated increased morbidity. Case ReportBeing a rare condition, two cases of voluntary shoulder dislocation are reported. The first patient is a boy, 12-year-old with 2 years of voluntary bilateral posterior shoulder dislocations, with 17-year follow-up, the patient did well. The second case is an 8-year-old girl with voluntary posterior dislocation of the right shoulder who after three year follow up responded well to conservative treatment. DiscussionThe risk of developing osteoarthritic changes or the appearance of chondral lesions are major long-term concerns with this disease. Currently there is no specific treatment consensus and little evidence regarding the prognosis of this condition.Voluntary shoulder dislocation is a rare entity of unknown etiology. Patients report no history of trauma but is often associated with psychiatric conditions. Prospective studies have reported favorable results of nonoperative treatment during childhood.Evidence Level: IV

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

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.

A Case Report of Bilateral Symmetric Posterior Hip Dislocation: Why It Is More Common in Males?

A Case Report of Bilateral Symmetric Posterior Hip Dislocation: Why It Is More Common in Males?

Traumatic Posterior Dislocation of Bilateral Mandible Condyles into External Auditory Canal Treated with Midline Mandibulotomy: A Rare Case Report and Review of Literature.

Posterior dislocation of the condyle from the glenoid fossa fracturing the anterior wall of the canal and ultimately restricting lower jaw movements is a rare condition. It may occur due to lax intra-articular ligaments or periarticular tissue or as a result of injury to the chin region. Very few cases of this condition are reported in the literature. The purpose of this article is to present a rare case report and review of literature related to posterior dislocation of bilateral mandible condyles to the external auditory canal, its diagnosis, and treatment with midline mandibulotomy. We used conservation methods to reduce it initially but not succeeded. Then we used midline mandibulectomy to reduce the individual condyle to its original position without opening the condyle region. We achieved a successful reduction of the dislocation and achieved with good occlusion and postoperative mouth opening. No complications like recurrence and TMJ ankylosis occurred. Bilateral posterior dislocation is a rare condition; proper clinical, radiographic diagnosis, and early treatment with manual or surgical intervention are required to avoid complications.

An Approach to the Management of Bilateral Posterior Shoulder Dislocations Following Seizure: Case Report, Literature Review, and Proposed Treatment Algorithm

Bilateral posterior shoulder dislocations in patients with seizure disorders are an uncommon injury that is difficult to treat. Surgery is typically required and impaction lesions often require bone reconstruction procedures. Seizures in the early postoperative period can have disastrous consequences when bone restoration procedures are disrupted. However, delaying treatment of persistent instability can cause further joint damage and bone loss potentially leading to the need for humeral head replacement. Our purpose is to introduce an approach to treating the young patient who presents with bilateral posterior dislocations related to a seizure. We report a case, describe the surgical techniques used, and propose an algorithm for managing the treatment of a young patient who presents with bilateral posterior dislocations related to a seizure. At her most recent follow-up (57 mo postoperative for the left shoulder and 41 mo postoperative for the right shoulder), she denied any apprehension or instability in either shoulder and had no further dislocations. She reported mild chronic pain in both shoulders, worse in the right than the left. She has a smooth passive range of motion with no crepitus in either shoulder. Her range of motion in forward elevation/external rotation/internal rotation is 150/45/L3 on the left and 50/150/L3 on the right. Strength is 5/5 in all planes and her subscapularis is clinically intact bilaterally. Our case illustrates the importance of early surgical intervention, resulting in functional, stable shoulders even in the face of medically and surgically intractable epilepsy. This algorithm highlights the importance of multidisciplinary cooperation and early surgical intervention to minimize bone loss and avoid joint replacement.

Bilateral Posterior Fracture Dislocations of the Shoulder Treated with Bilateral Reverse Total Shoulder Arthroplasty

Bilateral Posterior Fracture Dislocations of the Shoulder Treated with Bilateral Reverse Total Shoulder Arthroplasty

A case report: Simultaneous bilateral posterior shoulder and unilateral central acetabular fracture dislocations secondary to epileptic seizure

Fracture dislocations of extremities are a possible complication following epileptic seizures. Management mainly depends on the severity of the injury and the current medical status of the patient. We describe a rare case of bilateral posterior shoulder and unilateral central acetabular fracture dislocations without direct trauma after a convulsive seizure related to lung cancer with brain metastases. Two weeks after the seizure, we performed an open reduction and internal fixation (ORIF) with locking plate to treat bilateral posterior shoulder fracture dislocations when the patient’s neurological condition became more stable. However, nonoperative treatment was selected for the acetabular fracture dislocation because of the patient’s advanced-stage cancer. Since the patient was responding well to the newest target therapy for his lung cancer, and his life span is beyond our estimate, we, therefore, performed a total hip replacement 6 months later because of traumatic osteoarthritis development. The clinical outcome was satisfactory at the 6-month follow-up. Due to medical progress in non-small cell lung cancer treatment, we consider aggressive treatment may be necessary even in such advanced stage patients.

Bilateral Proximal Humerus Fracture - a Rare Combination with a High Complication Rate after Surgery.

Bilateral acute proximal humerus fractures are rare. There are no data available about these bilateral injuries. The aim of the study was to analyse bilateral proximal humerus fractures retrospectively in terms of incidence, complications and revisions. All bilateral proximal humerus fractures were evaluated retrospectively using the institution's database, with the focus on cause of the injury, fracture severity and the clinical course compared to published information on monolateral proximal humerus fractures. Bilateral posterior dislocation fractures were excluded, because these fractures are a separate entity. Between 2005 and 2016, n = 17 patients were primarily treated within our hospital for an acute proximal humerus fracture on both sides (n = 12 female, n = 5 male, average age: 68 years; overall 34 proximal humerus fractures). The general trauma mechanism was a fall on both arms (82% [18% polytrauma]). There were 65% displaced 3-/4-part proximal humerus fractures. Angle-stable plate osteosynthesis was performed predominantly (64%), followed by fracture prosthesis (18%; tension wiring: 3%; non-operatively: 15%). Overall, n = 10 patients (59%) or n = 18 (53%) proximal humerus fractures developed a complication, primarily with loss of reduction or implant loosening (44%). In n = 14 (78%) of the complications further operations were necessary. Alcohol abuse was increasingly found in 29% of the cases within the bilateral patient cohort compared to patients with monolateral fractures. Bilateral proximal humerus fractures are mainly associated with comminuted displaced fractures and a higher complication rate in comparison to monolateral fractures after surgical treatment.

Mclaughlin Procedure Treatment of Bilateral Sequential Posterior Dislocation Fracture of the Shoulder: A Case Report

Posterior dislocation of the shoulder is extremely rare condition. Common etiologic causes are extreme trauma, epilepsy and electroconvulsive therapy. Most cases are misdiagnosed due to inappropriate phisical examination and/or inadequate radiologic evaluation. In the literature several operation technics are described. Here we present a case with posterior dislocation of left shoulder after succesful treatment of right shoulder.

Double trouble: Bilateral spontaneous posterior dislocation of cataractous lens

Subluxation or dislocation of clear or cataractous lens occurs commonly following ocular trauma or in association with systemic or other ocular risk factors. Spontaneous dislocation of lens in the absence of any of these risk factors is very rare. We report a case of bilateral spontaneous posterior dislocation of cataractous lens in a 64-year-old man who was on long-term antipsychotic medications with no preceding history of trauma or other risk factors. Simultaneous bilateral pars plana vitrectomy with lensectomy and glued scleral fixated intraocular lens implantation was done under general anesthesia, following which he had a good visual recovery.

Bilateral Posterior Dislocation of the Shoulder Caused by Seizure after Tramadol Usage; A Case Report And Literature Review

Posterior dislocation of the shoulder accounts for 2-4% of all shoulder dislocations. Non-epileptic seizures resulting from drug usage, is an important cause of posterior shoulder dislocation. In this case report, we described a case of bilateral posterior shoulder dislocation due to convulsion after tramadol usage and reviewed the literature recapitulating the causations of drug-induced seizures, non-traumatic shoulder dislocation, the mechanisms of dislocation related to seizure, and which are detected by imaging techniques.

Bilateral Posterior Hip Dislocation in an Unrestrained Driver

Bilateral Posterior Hip Dislocation in an Unrestrained Driver

Bilateral Posterior Dislocation of the Shoulder Caused by Seizure after Tramadol Usage; A Case Report And Literature Review

Bilateral Posterior Dislocation of the Shoulder Caused by Seizure after Tramadol Usage; A Case Report And Literature Review

The management of bilateral posterior fracture dislocations of the shoulder: a case series illustrating management options.

Although dislocation of the shoulder is a relatively common event, the overwhelming majority of injuries are anterior. Posterior shoulder dislocation is more uncommon, comprising between 3% and 5% of all shoulder dislocations. One percent of shoulder dislocations involve a fracture, whereas only 0.9% of the 1500 cases reported by Neer (J Bone Joint Surg Am 1970; 52:1077-89; J Bone Joint Surg Am 1970; 52:1090-103) concerned posterior fracture dislocations. Bilateral posterior fracture dislocation is an even rarer event, comprising just 5% of all posterior fracture dislocations. Given the rarity and relative poor outcome often observed after these severe injuries, it is important that upper limb function is optimized. Bilateral posterior fracture dislocations of the shoulder pose a difficult clinical challenge that requires careful management planning. To date, there have been three isolated case reports of using contralateral osteochondral humeral autograft and hemiarthroplasty. We report our experiences and clinical outcomes in managing four such cases using a variety and combination of treatments, including the first reported use of reverse shoulder arthroplasty with contralateral osteochondral humeral autografting. Shoulders reconstructed with humeral autograft demonstrated superior Oxford Shoulder Scores and an improved range of motion, as measured by a markerless machine vision system, compared to hemiarthroplasty. Our results support the use of a contralateral humeral autograft in bilateral posterior shoulder fracture dislocation.

Bilateral Traumatic Symmetric Posterior Hip Dislocation in a Teenager

Traumatic hip dislocation is rare in children, accounting for 2 to 5% of all traumatic dislocations. Bilateral hip dislocations are unusual. There is no consensus on the protocol after reduction. We report the case of a 14-yearold girl sustaining a bilateral posterior hip dislocation after a road traffic accident in a limited resource setting. The concentrically reduction was performed 22 hours after the admission. Post-reduction radiograph showed an intraarticular fragment in the left hip and CT scan prescribed has not been performed. The patient was kept on bilateral skin traction for 3 weeks. At the end of the period of traction, bilateral hip spica cast was applied for 3 weeks. At 4 years 11 months follow-up the hips were pain-free. CT scan showed osteoarthritis secondary to AVN of the femoral head on the right hip.

Unusual Posterior Traumatic Hip Dislocations at Yopougon/Abidjan Teaching Hospital

Traumatic dislocation of the hip is quite rare and accounts for 2% - 5% of all dislocations. We report on a case of a bilateral posterior hip dislocation associated with symmetric acetabular fracture and two cases of infracotyloid dislocation. The report included 2 men and one woman. The mean age of patients was 33 years. All dislocations followed a road traffic accident. Non-operative closed reduction was achieved within 19 hours of admission. The average follow-up time was 15 months. The hips were stable, mobile, and painless; and there was no radiographic sign of avascular necrosis of the femoral head.

Unique simultaneous dual mechanism based bilateral femoral head fracture secondary to posterior dislocation of hip: A rare case report

Hip joint being surrounded by strong ligaments and muscles is considered a stable joint and dislocations are exceptionally rare. Majority of the dislocations are unilateral and are secondary to a high velocity traumatic injury making a bilateral dislocation a rare entity. Due to high velocity injury, femur head and acetabular wall fractures have been associated to dislocations and each of the associated injuries occurs with a different mechanism of injury. In view of its rarity we hereby have reported a unique mechanism based case of bilateral posterior dislocation of hip with bilateral femoral head fracture.

Reconstruction for elbow instability caused by congenital aplasia of the ulnar coronoid process—a case report

A 13-year-old girl presented at our tertiary referral center with bilateral posterior radial head dislocation and aplasia of the ulnar coronoid process (Figure 1). She was pain-free, had a 30-degree lack of elbow extension, limited forearm pronation and supination (80–20 degrees on the right side, 80–0 degrees on the left side), but no signs of elbow instability. After several years without any relevant restrictions during her daily life activities, she returned to our outpatient clinic at the age of 17 with increasing pain on both sides and distinct radiological signs of posterior humeroulnar dislocation due to aplasia of the ulnar coronoid process (Figure 2). A review of the literature did not yield any information about that specific deformity or any possible treatment options. We decided to reconstruct the right elbow via an anteromedial approach, using a tricortical iliac crest bone graft as a coronoid equivalent and artificial bony restraint to the elbow joint.