Bilateral Shoulder Dislocation Research Articles

A rare case of bilateral antero-internal shoulder dislocation: A case study and review of the literature

Introduction: Although anterior dislocations of the glenohumeral joint are the most frequent type of dislocation, bilateral forms are very rare [1] dominated by the posterior variant. We report a new case of bilateral anterior dislocation of the glenohumeral joints and discuss the mechanism and treatment. Case report: This concerns a 55-year-old patient, who presented to the emergency room with closed trauma to both shoulders in undetermined circumstances. The patient reported a disturbance of consciousness followed by a post-critical coma and generalized tonic-clonic seizures according to witnesses. Clinical examination revealed total functional impotence of the upper limbs, with the following findings: filling of the delto-pectoral groove, bilateral external axe strike, oedema of both shoulders. X-rays of both shoulders revealed bilateral anterior glenohumeral dislocation, with a nondisplaced fracture of the left great tuberosity. Discussion: Bilateral shoulder dislocation is a rare occurrence typically associated with specific etiologies such as epileptic seizures, electrical or neuromuscular disorders, or traumatic events. This report presents a case of bilateral shoulder dislocation in a patient with no history of ligament hyperlaxity, categorized under Brown's classification as traumatic origin. Despite the rarity of this presentation, similar unusual mechanisms of shoulder dislocation have been reported in the literature, including cases where each shoulder dislocated due to different mechanisms.

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.

Full-thickness bilateral rotator cuff tears as a result of a bench-pressing accident: case report and literature review of treatment of bilateral rotator cuff tears

Rotator cuff injuries are frequent pathologies presenting to orthopedic surgeons. These injuries especially occur among older adults due to intrinsic or extrinsic degeneration. They can however present in young athletes, but as result of different etiologies. Overhead athletes may incur rotator cuff injuries due to repetitive trauma. Bilateral simultaneous traumatic shoulder dislocations have been reported in the literature following acute trauma or weight-lifting activity, but bilateral traumatic rotator cuff tears following bench pressing is an unusual presentation in a young individual. To our knowledge, there has been no previous report describing this injury. This article presents a case of a young male athlete who had bilateral rotator cuff tears after a barbell bench press. Both shoulders were treated operatively in a sequential manner, three months apart, and the patient regained excellent functional status 24 months postoperatively.

Rare Case of a Bilateral Shoulder Dislocation in a 28 Years-Old Patient: About a Case and Review of the Literature

Pure anterior bilateral shoulder dislocations are rare clinical entities. About thirty cases are described in the literature. We report a case of a patient of 28 years old, with no known pathological history, who was received in the emergency room following a public road accident. We discuss the unusual mechanism of this trauma about this dislocation and its treatment.

A rare case of bilateral inferior shoulder dislocation and review of literature

A rare case of bilateral inferior shoulder dislocation and review of literature

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.

Epidemiology and specific features of shoulder injuries in patients affected by epileptic seizures

PurposeEpileptic seizures can cause multiple shoulder injuries, the most common of which are dislocations, recurrent instability, fractures, and isolated lesions of the rotator cuff. Currently, only limited literature exists which describes the frequency and types of lesions in cohorts of epileptic patients and the corresponding treatment outcome. This study aims to document the occurrence of shoulder lesions in patients affected by seizures and to provide detailed information on trauma dynamics, specific lesion characteristics and treatment complications.MethodsAll patients referring to a tertiary epilepsy center were screened for shoulder injuries and the clinical records of those sustaining them during a seizure were reviewed. Demographic information, lesions’ characteristics and trauma dynamics were analysed, as wells as—when carried out—the type of surgical intervention and any postoperative complications.ResultsThe average age at the time of injury of 106 included patients was 39.7 ± 17.5 years and a male predominance was recorded (65%). Bilateral injuries occurred in 29 patients, simultaneously in 17 cases. A younger age, bilateral shoulder injuries and shoulder dislocations were significantly associated with the occurrence of a shoulder injury solely by muscular activation (p = 0.0054, p = 0.011, p < 0.0001). The complication rate in 57 surgically treated patients with follow-up data was 38.7%, with recurring instability being the most frequently reported complication (62.5%).ConclusionsUncontrolled muscle activation during a seizure is a distinctive but not exclusive dynamic of injury in epileptic patients, accounting for more than the half of all shoulder lesions, especially in the younger. This can lead both to anterior and posterior dislocations or fracture-dislocations and is frequently cause of bilateral lesions and of instability recurrence after surgery. The high complication rates after surgical treatment in this selected subgroup of patients require that appropriate preventative measures are taken to increase the probability of treatment success.Level of evidenceCohort study, level III.

A rare case of bilateral antero-internal shoulder dislocation in a judo player: a case study and review of the literature

Pure anterior bilateral shoulder dislocations are rare clinical features, especially in traumatic forms. They are most often posterior, occurring during an epileptic seizure. Few cases are described in the literature, and the mechanism varies from case to case. We report a specific case of pure bilateral anterior shoulder dislocation in a 29-year-old judo player following an accident during his training and discuss the circumstances, mechanism, treatment, and prognosis.

Central Cord Syndrome Mimic-Bilateral Anterior Shoulder Dislocations: A Case Report

Unilateral anterior shoulder dislocations are the most common major joint dislocation. However, bilateral shoulder dislocations are rare, and when present are mostly posterior. Given the rarity of this clinical entity, many emergency physicians would suspect central cord syndrome in a patient who presents with disproportionate weakness of the arms compared to the legs post trauma. This case report describes a 65-year-old woman presenting with inability to move both arms after she tripped. She displayed signs consistent with an initial diagnosis of central cord syndrome. Appropriate investigations led to the correct and timely diagnosis of bilateral anterior shoulder dislocations. Bilateral shoulder dislocations are uncommon. Central cord syndrome can mimic similar clinical presentations, and vice versa. It is important for emergency physicians to recognise these pitfalls in diagnosis, and to increase awareness of this clinical entity to avoid future late or missed diagnoses.

Bilateral Anterior Shoulder Dislocation after an Episode of Grand-Mal Seizure: A Case Report and Literature Review

Background: Among all joint dislocations, dislocations of the shoulder are the most common. Although posterior shoulder dislocation is infrequent, it is more common following seizures. Trauma, electrocution, and seizures can cause bilateral shoulder dislocation. Anterior shoulder dislocations can be accompaniment by greater tuberosity (GT) fractures, Bankart fractures, and other complications such as rotator cuff tears and neuro-vascular injuries.&#x0D; Case Report: This article describes a 19-year-old boy who suffered from bilateral anterior shoulder dislocation due to an episode of generalized seizure, which happened after taking tramadol.&#x0D; Conclusion: Any sign of shoulder pain in a patient who has experienced a generalized tonic-clonic seizure should warrant full radiographic evaluation to prevent the complications.

Bilateral Luxatio Erecta – Etiology, Diagnosis and Management

Luxation erecta is a rare form of shoulder dislocation, bilateral inferior shoulder dislocation is very rare and few cases have been published in the literature. We present a case of a male, fell down the ladder, presented with bilateral luxation erecta treated with close reduction, immobilisation and rehabilitation.

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.

Unusual presentation of bilateral inferior shoulder dislocation following a trivial fall in an elderly female: a case report

Background. Bilateral inferior dislocation of the shoulder joint is infrequent. This usually results following significant impact from forceful hyperabduction or direct axial loading in the abducted position. We describe the case of bilateral inferior shoulder dislocation following a trivial fall on outstretched arms in an elderly female. A 75-year-old female who was on treatment for type 2 diabetes and hypertension, presented to the emergency department with painful inability to move both shoulders following a trivial fall. Her both shoulders were fixed at the 90 degree abducted position, the acromion processes were prominently palpable and both humeral heads were palpable in the axillae. X-ray confirmed the diagnosis of bilateral inferior dislocation of the shoulder joint. Closed reduction was successfully achieved using a single step levering manoeuvre with one hand applying traction at 90 degree abduction and the other hand levering the humeral head towards the glenoid. Post-procedure was uneventful with satisfactory functional outcomes. We described an unusual presentation of bilateral inferior dislocation of the shoulder joint following a trivial fall in an elderly female. The single step levering manoeuvre was successful in achieving reduction.

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-dislocation of the shoulder after epileptic seizures: A case report

Bilateral shoulder dislocation is a rare entity usually caused by sports injuries, electrical shock, or electroconvulsive therapy. Epileptic seizures account in less than 2% of cases . Almost always posterior, bilateral shoulder dislocation is usually due to unbalanced tonic muscles contraction and may be associated with fracture of the upper end of the humerus . The diagnosis is made by pertinent clinical examination and appropriate standard X ray requests and may easily be missed. Delayed management may lead to irreversible sequelae. We report a case of 46- year-old male who sustained bilateral posterior shoulder fracture- dislocation following epileptic seizures. The aim is to highlight diagnosis circumstances and the results of the management.

Bilateral Shoulder Dislocation after Ski Injury

Bilateral Shoulder Dislocation after Ski Injury

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 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 Divergent Shoulder's Fracture Dislocation Case in an Ischemic Stroke Patient.

Introduction:The literature review revealed that nowadays only about 15 cases of bilateral shoulder dislocation associated with the fracture of the upper end of the humerus have been published. The triad of lesional mechanism designated by the triple syndrome E composed of epilepsy, electrocution, and external trauma was the circumstances noted in which these fractures dislocations occur with migration of the two humeral heads either forward or backward.Case Report:An architect of 36-year-old, right-handed, was admitted in emergency department for loss of knowledge of progressive installation. At admission the blood pressure, pulse, and temperature were normal. There was a right hemiparesis predominantly in brachiofacial side and an aphasia. After intensive resuscitation measures, the cerebral computed tomography scan revealed a left temporoparietal hypodensity area affecting the middle cerebral artery superficial territory with a mass effect compatible with acute ischemic stroke. During the hospitalization, episodes of generalized tonic-clonic convulsions appeared with a fever at 39°C and a leukocytosis at 35 thousand on the 5th day. These convulsions caused on the right shoulder an anterior dislocation under coracoid, associated with a fracture of the greater tubercle and on the left shoulder, posterior dislocation with much displaced comminuted articular proximal humeral fracture. We did reduction by external maneuvers for the right shoulder and open reduction with internal fixation by anatomical plate of left shoulder lesions. In the immediate aftermath of surgery, he presented episodes of agitation which led to the dismantling of the left shoulder fixation. He was evacuated to the North Country where an ablation of the left shoulder material and stabilization by locked plate were carried out. The sequelae were marked by the occurrence of an osteomyelitis with osteolysis of the entire upper right humerus extremity. It will require an inverted prosthesis.Conclusion:The surgical treatment must be done by a solid assembly and consultation with neurologists and anesthetists is essential. This multidisciplinary management could prevent any convulsive postoperative seizures that would risk sacrificing all therapeutic efforts.