A rare injury to a rear seat passenger: bilateral fracture dislocation of the shoulders

Abstract

SUMMARYInjury prevention measures in automobiles are mainly focused on the front seat passengers and driver. In the event of a head-on collision, rear seat passengers usually escape with minimal injuries. Most commonly observed injuries to rear passengers are to the head, chest wall or lower extremities. We report a case of bilateral anterior dislocation of the shoulders with asymmetrical fractures of the greater tuberosities in a 42-year-old man who was apparently injured in a head-on collision while travelling in a car as an unstrapped rear seat passenger. This kind of injury pattern in an unrestrained rear seat passenger is very unusual and has not been previously described. BACKGROUND

Bilateral anterior shoulder dislocations: A review of two cases and the relevant literature

“…GT and multipart proximal humerus fractures were present in traumatic and IMC dislocations with the same distribution. GT fractures were more common in traumatic indirect force dislocations 8,34,52,63,87,99,110,112 and complex proximal humerus fractures in direct hit and complex mechanisms 55 . Nondisplaced associated coracoid process fractures seemed underestimated by the initial radiographs.…”

“…Acute BSASD are mainly managed by closed reduction (CR) 7,8,13,14,17,22,24,27‐30,32,33,35,42,45,47‐52,54,56,58,60,62,63,65,66,68‐72,74‐77,80‐82,84,86‐88,90‐94,96‐99,101‐104,107‐113,116,118 . The presence of an associated lesion often necessitates operative management.…”

“…The presence of an associated lesion often necessitates operative management. Displaced GT fractures were managed by plate and screws with washers 96,99 ; anchors were used for rotator cuff tenodesis 99,110 ; and some authors performed primary Bankart‐like procedures 102 . Complex fracture‐dislocations require extrication of the long biceps tendon 34 and open reduction and internal fixation (ORIF) 34,37,45,55,73,85 .…”