Bilateral posterior shoulder dislocation after electrical shock: A case report

Abstract

IntroductionPosterior dislocation of the shoulder is a rare and commonly missed injury. Unilateral dislocations occur mostly due to trauma. Bilateral posterior shoulder dislocations are even more rare and result mainly from epileptic seizures. Electrical injury is a rare cause of posterior shoulder dislocation. Injury mechanism in electrical injury is similar to epileptic seizures, where the shoulder is forced to internal rotation, flexion and adduction.Presentation of caseThis report presents a case of bilateral posterior shoulder dislocation after electrical shock. We were able to find a few individual case reports describing this condition. The case was acute and humeral head impression defects were minor. Our treatment in this case consisted of closed reduction under general anesthesia and applying of orthoses which kept 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. 20 months postoperatively, at final follow-up, he was painless and capable of performing all of his daily activities.DiscussionThe amount of bilateral shoulder dislocations after electrical injury 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.ConclusionPhysical examination and radiographic evaluation are important for quick and accurate diagnosis.

Acute Rotator Cuff Tears due to Low Voltage Electrical Injury: A Case Report

“…Although other possibilities (rupture by direct contact) are also conceivable, this case suggests that sudden muscle contraction may play an important role in traumatic tendon rupture. In addition, several reports showed that electric current caused powerful muscle contractions which were strong enough to produce fractures and dislocations which could lead to traumatic tendon rupture [ 4 , 5 , 8 ].…”

“…This can be explained by electric current which directly contacted on the posterolateral side of his shoulder. Shoulder injuries related to electric current have been reported as a posterior dislocation and fracture of the proximal humerus and scapula [ 4 , 5 ]. Posterior dislocation of the shoulder due to forceful internal rotation is common during electrical injury, which suggests that the tetanic contraction acted primarily on the SSC, also only SSC rupture occurring through a similar mechanism has been previously reported [ 8 ].…”

“…However, more than 20 mA in this area may exceed the ‘let go threshold’ due to tetanic muscular contractions caused by the alternating current, which can be strong enough to cause joint dislocation and even fractures [ 2 , 3 ]. Clinical manifestations in the shoulder region include posterior dislocation or fractures [ 4 , 5 ]. Previous studies have reported that 2.3% to 17.7% of RCTs occurred after a fall or another form of trauma [ 6 , 7 ].…”

Manejo y tratamiento no quirúrgico de la luxación de hombro

“…La luxación posterior de hombro es poco común y es causada principalmente por trauma, convulsiones o descargas eléctricas (10). Abarca el 4% de todas las luxaciones de hombros.…”

Case Report: Floating Elbow with Posterior Shoulder Dislocation

“…Posterior dislocation of the shoulder is a rare and commonly missed injury. Also, combination of the fracture of the humerus with shoulder dislocation is a very rare injury [1][2][3][4][5][6].…”