Article: Bilateral posterior fracture-dislocation of the shoulder after epileptic seizure

We present a case of a 61 year-old woman who suffered a bilateral posterior fracture-dislocation of the shoulder after an isolated episode of epileptic seizure. The patient was diagnosed at our Emergency department with x-rays and CT scans after being found unconscious. An indication for bilateral shoulder hemiprosthesis implant was initially given. However, given the peculiar pattern of the fracture, the hemiprosthesis was implanted on one side only, while the other side was treated with ORIF with four cannulated screws. After the one year, the patient had resumed her previous activities and had no complaints. We performed a review of similar cases in literature and provided a rationale for our choice of treatment and the reasons for its success.

Citing Articles

Bilateral Posterior Fracture-Dislocation of the Shoulders Secondary to Uremic Encephalopathy.

Mencia M, Goalan R J Am Acad Orthop Surg Glob Res Rev. 2023; 7(1).

PMID: 37796759 PMC: 9820790. DOI: 10.5435/JAAOSGlobal-D-20-00255.

Bilateral Locked Posterior Fracture-Dislocation of the Shoulder After Epileptic Seizures Secondary to Cavernous Hemangioma: A Case Report and Literature Review.

Pangopoulos A, Papagiannis S, Koutas K, Kokkalis Z Am J Case Rep. 2023; 24:e940141.

PMID: 37337276 PMC: 10286635. DOI: 10.12659/AJCR.940141.

Bilateral Divergent Fracture Dislocations in a COVID-19 Patient Following a Hyponatremia-Induced Seizure.

Fares M, Abboud J Arch Bone Jt Surg. 2023; 11(5):369-372.

PMID: 37265532 PMC: 10231924.

Bilateral locked posterior shoulder dislocation overlooked for 15 months treated with the modified McLaughlin procedure: A case report.

Saylik M, Gokkus K Jt Dis Relat Surg. 2023; 34(1):226-233.

PMID: 36700287 PMC: 9903109. DOI: 10.52312/jdrs.2023.869.

Surgical management of bilateral concomitant posterior fracture-dislocation of the shoulder.

Ben Fadhel W, Ghrairi R, Sabathe S, Begue T Trauma Case Rep. 2022; 41:100691.

PMID: 36017398 PMC: 9396229. DOI: 10.1016/j.tcr.2022.100691.

References

1.

Robinson C, Akhtar A, Mitchell M, Beavis C . Complex posterior fracture-dislocation of the shoulder. Epidemiology, injury patterns, and results of operative treatment. J Bone Joint Surg Am. 2007; 89(7):1454-66. DOI: 10.2106/JBJS.F.01214. View

2.

Mynter H . XIV. Subacromial Dislocation from Muscular Spasm. Ann Surg. 1902; 36(1):117-9. PMC: 1430708. DOI: 10.1097/00000658-190207000-00014. View

3.

Din K, Meggitt B . Bilateral four-part fractures with posterior dislocation of the shoulder. A case report. J Bone Joint Surg Br. 1983; 65(2):176-8. DOI: 10.1302/0301-620X.65B2.6826625. View

4.

Paul J, Buchmann S, Beitzel K, Solovyova O, Imhoff A . Posterior shoulder dislocation: systematic review and treatment algorithm. Arthroscopy. 2011; 27(11):1562-72. DOI: 10.1016/j.arthro.2011.06.015. View

5.

Neer 2nd C . Displaced proximal humeral fractures. II. Treatment of three-part and four-part displacement. J Bone Joint Surg Am. 1970; 52(6):1090-103. View

6.

Hawkins R, Neer 2nd C, Pianta R, Mendoza F . Locked posterior dislocation of the shoulder. J Bone Joint Surg Am. 1987; 69(1):9-18. View

7.

Kokkalis Z, Iliopoulos I, Antoniou G, Antoniadou T, Mavrogenis A, Panagiotopoulos E . Posterior shoulder fracture-dislocation: an update with treatment algorithm. Eur J Orthop Surg Traumatol. 2016; 27(3):285-294. DOI: 10.1007/s00590-016-1840-5. View

8.

Brackstone M, Patterson S, Kertesz A . Triple "E" syndrome: bilateral locked posterior fracture dislocation of the shoulders. Neurology. 2001; 56(10):1403-4. DOI: 10.1212/wnl.56.10.1403. View

9.

Neer 2nd C . Displaced proximal humeral fractures. I. Classification and evaluation. J Bone Joint Surg Am. 1970; 52(6):1077-89. View

10.

Hertel R, Hempfing A, Stiehler M, Leunig M . Predictors of humeral head ischemia after intracapsular fracture of the proximal humerus. J Shoulder Elbow Surg. 2004; 13(4):427-33. DOI: 10.1016/j.jse.2004.01.034. View

11.

Shaw J . Bilateral posterior fracture-dislocation of the shoulder and other trauma caused by convulsive seizures. J Bone Joint Surg Am. 1971; 53(7):1437-40. View

12.

McLAUGHLIN H . Posterior dislocation of the shoulder. J Bone Joint Surg Am. 1952; 24 A(3):584-90. View

Bilateral Posterior Fracture-dislocation of the Shoulder After Epileptic Seizure