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      Neglected Bilateral Posterior Shoulder Fracture Dislocation in an Uncontrolled Seizure patient

      case-report

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          Abstract

          Posterior dislocation of the shoulder is a rare injury that occurs secondary to trauma and seizures. Diagnosis is often missed and treatment is challenging. Neglected posterior dislocation is associated with Hill-Sachs lesion which leads to locking of dislocation. Correct diagnosis is achieved by history taking, a physical examination and appropriate imaging. In neglected shoulder dislocation with uncontrolled seizure and humeral head defects of up to 45% the McLaughlin procedure shows excellent results at follow-up.

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          Incidence of associated injury in posterior shoulder dislocation: systematic review of the literature.

          Jonah Hébert-Davies, Dominique Rouleau (2012)
          Posterior shoulder dislocations are rare and often missed. Classically associated with seizures, very little is known about the incidence and type of associated injuries. Unfortunately, the majority of the literature consists of incidental reports or small case series. Our goal was to increase the strength of available data by performing a systematic review.
          Article 0 comments Cited 34 times – based on 0 reviews     Review now
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            Treatment of locked posterior fracture-dislocations of the shoulder by total shoulder arthroplasty.

            S Cheng, M Mackay, R R Richards (2015)
            Total shoulder arthroplasty is indicated in the treatment of locked posterior fracture-dislocations of the shoulder where there is extensive damage to the articular surfaces of the humerus and glenoid. This report reviews the surgical technique, postoperative rehabilitation program, and functional results of seven shoulders in five patients who had locked posterior dislocations of the shoulder. Activities involving overhead positioning of the arm and heavy lifting continued to be challenging for this group of patients. The American Shoulder and Elbow Surgeons' Shoulder Score improved from 20.1 before surgery to 55.6 after surgery (p = 0.018). The extrication of the posteriorly dislocated humeral head may be difficult from an anterior deltopectoral approach. The authors describe the use of a secondary posterior incision facilitating the extrication of the humeral head. In this series total shoulder arthroplasty reliably decreased the patients' level of pain, improved their range of motion, and significantly improved their level of function.
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              Bilateral dislocation of the shoulders.

              William Brown (1983)
              Ninety cases of bilateral dislocation of the shoulders, including seven previously unreported cases are discussed. Forty-nine per cent were due to convulsive seizures or electrocution, 23 per cent were traumatic and 36 per cent were atraumatic. This paper indicates that many attributed to trauma were probably due to unrecognized seizure, and neurological examination is indicated in all cases. Dislocations as a result of seizures or electrocution were often diagnosed late.
              Article 0 comments Cited 19 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Pak J Med Sci
                Journal ID (publisher-id): PJMS
                Title: Pakistan Journal of Medical Sciences
                Publisher: Professional Medical Publications (Pakistan )
                ISSN (Print): 1682-024X
                ISSN (Electronic): 1681-715X
                Publication date (Print): Jul-Aug 2015
                Volume: 31
                Issue: 4
                Pages: 1018-1020
                Affiliations
                [1 ]Moaath A. Amir, Department of Orthopedics, Military Hospital, Riyadh, Saudi Arabia
                [2 ]Bashir Alenazi, Department of Orthopedics, Military Hospital, Riyadh, Saudi Arabia
                [3 ]Richard K.H.Wyse, Dept. of Surgery, Imperial College London, UK
                [4 ]Waleed Tamimi, Biochemistry Section, Pathology Department, KAMC, Riyadh, Saudi Arabia
                [5 ]Omar Kujan, Alfarabi Dental College, Riyadh, Saudi Arabia
                [6 ]Tajdar Khan, College of Pharmacy, Salman bin Abdulaziz University, Al-Kharj, Saudi Arabia
                [7 ]Faris Q. Alenzi, College of Appl Med Sci, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia
                Author notes
                Correspondence: Faris Q. Alenzi, Ph.D. Professor of Immunology, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia. E-mail: f.alenzi@ 123456psau.edu.sa
                Article
                Publisher ID: PJMS-31-1018
                DOI: 10.12669/pjms.314.8231
                PMC ID: 4590399
                SO-VID: 3e140fb4-cb69-45cd-be14-7317349cf1c0
                Copyright © Copyright: © Pakistan Journal of Medical Sciences
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 26 May 2015
                Date accepted : 17 June 2015
                Categories
                Subject: Case Report

                Keywords: posterior dislocation,shoulder joint,trauma,seizures
                Data availability:
                Keywords: posterior dislocation, shoulder joint, trauma, seizures

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