Bilateral, locked, recurrent anterior shoulder dislocation: case report

Şanel, Selim; Şencan, Savaş; Öçgüder, Ali; Solakoğlu, Can

doi:10.5606/ehc.2015.12

Cited by 7 publications

(8 citation statements)

References 13 publications

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“…In those cases the time between the epileptic event and diagnosis ranged from 3 weeks to 9 months [8][9][10]. History of antiepileptic therapy, clinical findings of painful restriction of shoulder movement followed by plain radiographs of the glunohumeral joint are of paramount importance for early recognition of such cases [3,8,11]. There are cases in which the shoulder dislocation may be associated with an initial epileptic event (cases 3, 4 in Table 1).…”

Section: Discussionmentioning

confidence: 99%

Neglected Bilateral Anterior Shoulder Dislocation Following Epileptic Seizure: A Case Report and Literature Review

et al. 2019

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Anterior shoulder dislocations following an epileptic event are considered rare. An extremely rare case of a 41 year old female suffering from bilateral anterior shoulder dislocation with concomitant greater tuberosities fractures after an epileptic seizure is presented. The patient presented to the outpatient orthopaedic clinic due to persistent pain and restriction of shoulders movement, 4 weeks after an epileptic seizure. Clinical examination and radiological evaluation established the diagnosis of bilateral anterior shoulder dislocation with concomitant greater tuberosities fractures. Closed reduction was performed under general anesthesia. There are 12 such cases in the literature, including the present one. Thirty percent of these cases had a delayed diagnosis. It is of paramount importance to have a high clinical suspicion for myoskeletal injuries and especially for shoulder dislocations following an epileptic episode, even in the absence of a traumatic event.

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Section: Discussionmentioning

confidence: 99%

Neglected Bilateral Anterior Shoulder Dislocation Following Epileptic Seizure: A Case Report and Literature Review

et al. 2019

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“…Allograft reconstruction is preferable to arthroplasty in larger defects in relatively younger patients (Table I). [1,[7][8][9][10][11][12][13][14] For patients who have good bone quality of the residual head and an absence of relevant osteoarthrosis, reconstruction with an allograft represents a viable alternative to hemiarthroplasty or total joint arthroplasty for carefully selected larger defects. However, our follow-up time was too short to recommend whether avascular necrosis or graft collapse would develop, since posterior bilateral dislocation was usually experienced by middle-aged active males.…”

Section: Discussionmentioning

confidence: 99%

“…In conclusion, we suggest that hemior total arthroplasty should be reserved the final treatment of choice. [11] Ivkovic et al [2] Gerber et al [12] Kokkalis et al [9] Martínez et al [14] Torrens et al [1] Aparicio et al [6] Hawkins et al [7] Number of cases Clinical and radiological results, excellent.…”

Section: Discussionmentioning

confidence: 99%

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One-stage surgical treatment of neglected simultaneous bilateral locked posterior dislocation of shoulder: a case report and literature review

Elmalı

Taşdemir

Sağlam

et al. 2015

Eklem Hastalik Cerrahisi

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Bilateral posterior or anterior dislocations of the shoulder joint are rare. [1,2] Most posterior shoulder dislocations have been attributed to high energy trauma, seizures or electroconvulsive therapy. [3] Misdiagnosis of this injury may occur in 50% to 79% of patients, most commonly due to lack of clear clinical signs and accurate imaging study findings. [4,5] Computed tomography can quantify the involvement of the articular surface of the humeral head and identify fractures of the tuberosity, surgical neck, or glenoid. In addition, magnetic resonance imaging has been widely used to reveal posterior cuff tears and posterior avulsion lesions.[6] Treatment of neglected posterior dislocation of the shoulder is challenging.This report describes successful treatment of a simultaneous locked bilateral posterior dislocation of the shoulder with an associated large impression fracture of both articular surfaces of the humeral head due to an epileptic seizure. Defect of the humeral head on right side which was more than 40% of the articular surface was treated with osteochondral allograft femoral head, while a lesser articular defect was treated with the modified McLaughlin technique using absorbable suture anchors in the left side in a one-stage operation. ÖZİki taraflı eş zamanlı kilitli arkaya omuz çıkığı oldukça nadirdir. Bu yazıda grand mal tipi epilepsi nöbetinden sonra her iki humerus başının anteromedial yüzeyinde büyük impresyon kırığı ile birlikte redükte edilemeyen iki taraflı arkaya kilitli omuz çıkığı gelişen 59 yaşında erkek bir olgu sunuldu. Direkt grafiler ve bilgisayarlı tomografide sağ tarafta artiküler yüzeyin %40'ından fazla, sol tarafta %30 oranında defekt saptandı. Hastaya tek seansta sağ tarafına femur başı osteokondral allogrefti ile ve kendisine tutunan subskapularis tendon ile birlikte osteotomize edilen tüberkulum minus'un defekt içerisine transferi (modifiye McLaughlin tekniği) uygulandı. On dört aylık izlemde hasta ağrısız, omuz eklemi stabil ve fonksiyonları tatminkar idi.Anahtar sözcükler: İki taraflı omuz çıkığı; kilitli çıkık; tedavi. ABSTRACTSimultaneous bilateral locked posterior dislocation of the shoulder is a rare injury. Herein, we present a 59-year-old male case with a three-month history of an irreducible locked bilateral posterior dislocation of the shoulders with an associated large impression fracture on the anteromedial aspect of both humeral heads after a grand mal type epileptic seizure. Plain X-ray and computed tomograph revealed a defect on the right side more than 40% of the articular surface, and on the left side, 30%. He was treated with a one-stage operation with a reconstruction of femoral head osteochondral allograft on the right side and transfer of the osteotomized tuberculum minus with its attached subscapularis tendon into the defect (modified McLaughlin technique) on the left side. At 14 months during follow-up, the patient was pain-free with stable shoulder joints and satisfactory functionality.

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“…It usually occurs secondary to epileptic seizure and most of them are posterior. [1,2] Posterior shoulder dislocations are frequently associated with an anterior impression fracture of the humeral head. The size of this impression defect, the reverse Hill-Sachs or the McLaughlin lesion designates the treatment.…”

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confidence: 99%