Bilateral shoulder dislocations are a rare occurrence. 1-6 The two humeral heads dislocate from the scapular glenoid fossa in the same direction (bilateral symmetric shoulder dislocations or BSSD) or in different directions (bilateral asymmetric shoulder dislocations or BASD). There are three subtypes of BSSD (posterior, 1,2 anterior, 3 and inferior 4). BASD are classified as anteroposterior (one side anterior and the other side posterior) 5 or anteroinferior (one side anterior and the other side inferior). 6 Dislocations are acute or recent when recognized in the 21 days from the trauma. After 21 days, dislocations are called chronic or old. Bilateral symmetric posterior shoulder dislocations are the most common type since Cooper in 1839 1 and Myenter in 1902 2 reported the first cases. The literature found less commonly bilateral symmetric anterior shoulder dislocations (BSASD). 7 We report two cases of BSASD, one acute and one chronic case, both after epileptic seizures. We discuss the epidemiology, etiology, mechanism of injury, treatment, and outcome features through an extensive literature review of 133 BSASD reported cases. 3,7-118 2 | CASE HISTORY 2.1 | Case 1 A 30-year-old male patient complained of bilateral shoulder pain at our ED. The patient woke up at night on the ground, a few minutes after falling from bed, but with no recollection of the fall. He had no prior history of epilepsy nor diabetes. An inaugural epileptic grand mal seizure was suspected. At admission, he presented with bilateral shoulder sulcus signs with an inability to rotate his arm internally (Figure 1). The neurovascular status was normal at both shoulders. Bilateral shoulder AP and Bloom-Obata views revealed bilateral subcoracoid anteromedial glenohumeral dislocation without associated fracture (Figure 2). Closed reduction of both shoulders was performed under general anesthesia. With the patient in the supine position,
Background: The aim of this study was to describe the clinical, biological and x-ray presentation of Septic Chronic Multifocal Osteomyelitis (SCMO) and discuss the therapeutic difficulties of this pathology in an African Sub-Saharan teaching hospital. Patients and Methods: A retrospective study was conducted in the Orthopedics and Trauma department of the university teaching hospital of Bobo-Dioulasso (Burkina Faso). Over a period of two years, we selected all cases of chronic osteomyelitis. We studied the epidemiological, diagnostic and therapeutic aspects of SCMO cases. Results: Eleven cases of SCMO were identified. The mean age of the patients was 11.8 years and the sex ratio was 1.75. There were 7 rural patients. The mean time to visit the hospital was 158 days. The most common reasons for consultation were pain (10 cases), swelling (9 cases), and fever (7 cases). Two were sickle cell patients. The most affected bones were the femur (10 cases), the tibia (9 cases) and the fibula (6 cases). The most frequent specific radiological lesions were sequestra (6 cases) followed by pandiaphysitis.
Purpose: Traumatic hip dislocations (THD) are rarely reported from developing countries. The aim of the current study is to describe the trauma, the presentation, the treatment and the outcome patterns of THD received in the trauma unit of an emergency department (ED) in west Africa. Patients and Methods: A retrospective ongoing study from 2008 to 2014 was performed at the ED. All patients over 15 years with an unreduced THD and an anteroposterior pelvic radiograph were studied. Data were collected and analyzed by means of a statistical software. Results: A total of 50 THD were included in the study. We found an average of seven dislocations per year with a mean age of 36 years mainly males (n = 37). Road traffic accidents by motorcycle (n = 20) were the common circumstance of trauma. Forty-five extra-pelvic THD were diagnosed. According to the Bigelow classification, THD were classified posterior (n = 33), anterior (n = 10) and irregular (n = 2). Associated acetabular fractures (n = 36), ipsilateral lower limb fractures (n = 10) and sciatic nerve palsy (n = 2) were also found. The THD cases were treated by closed reduction (n = 34), open reduction (n = 6) and Girdlestone procedure (n = 1). The outcome after 16 months showed 21 good and excellent functional results and one death. The short term complications were post traumatic arthritis (n = 10) and osteonecrosis (n = 2). Conclusion: The THD occurrences are important in our emergency department. They are characterized by the place of motorcycle accidents and by the delayed reduction due to hospital's locations and numbers and beliefs. A reduction before four hours, an earlier rehabilitation, a non-use of traction and a short hospitalization time below 14 days gave better results.
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