Bilateral posterior four-part fracture–dislocations of the shoulders following electric shock

Bilateral posterior fracture-dislocation of the shoulder is a very rare injury. Almost 50% of bilateral posterior dislocations are due to a convulsive seizure, rising to 90% if the dislocations are associated with fractures. Electric shock accounts for less than 5% of bilateral posterior dislocations of the shoulder. A systematization of the clinical and radiological approach, followed by an early diagnosis and proper surgical treatment is essential. Authors report 2 cases of bilateral posterior fracture-dislocation of the shoulder, one caused by a convulsive seizure and the other by an electric shock. A review of literature and a treatment protocol are also presented.

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“…[5] Good results can be expected only if the anatomy is respected and if the procedure provides a stable joint.…”

Section: Discussionmentioning

confidence: 99%

“…[5717] In patients over 70 years of age with locked dislocation or fracture-dislocation associated with rotator cuff tear and severe distortion of the bony anatomy, a reverse prosthesis is likely to provide good results. [18]…”

Section: Discussionmentioning

confidence: 99%

Bilateral posterior fracture-dislocation of the shoulder: Report of two cases

Claro

Sousa

Massada

et al. 2009

Int J Shoulder Surg

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“…According to Cooke and Hackney, 3 of all dislocations, 4% are posterior and only 1% are associated with fractures. Fractures of the proximal humerus account for 4% to 10% of all fractures; the most common trauma mechanism is a fall from the patient's own height.…”

Section: Introductionmentioning

confidence: 99%

Posterior four-part fracture-dislocations of the proximal humerus: clinical and functional evaluation of osteosynthesis treatment

Oliveira

Graça

Fanelli

2018

Revista Brasileira de Ortopedia (English Edition)

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ObjectiveTo evaluate patients diagnosed with posterior four-part fracture-dislocations of the proximal humerus, that were surgically treated with osteosynthesis, regarding their clinical and functional outcomes.MethodsA prospective observational study of eight patients from the same hospital institution in the interior of São Paulo State (Brazil), through individual interviews using the UCLA, DASH, and Constant international scores. The active movements included in the scores plus the range of motion of the affected and non-affected limb were measured. The affected shoulder's radiographs were requested to verify bone conditions and the fixation of the osteosynthesis.ResultsThe rating of eight patients by the international scores indicated that seven of the eight patients presented good clinical and functional evolution of the affected limb; this represents 87.5% of the evaluated individuals.ConclusionSurgical treatment with osteosynthesis performed during the acute period (

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“…When both humeral head and glenoid cavity are damaged, a total shoulder arthroplasty may be considered [ 17 ]. Therefore the treatment should be decided depending on the type of lesion, the interval of time between trauma and treatment, age of the patient and occupation [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Bilateral posterior fracture-dislocation of the shoulders following epileptic seizures: a case report and review of the literature

et al. 2015

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BackgroundBilateral posterior fracture-dislocation of the shoulders is an uncommon complication of grand mal seizures. We report a case of bilateral posterior dislocation of the shoulders with proximal humeral fractures following epileptic seizures. A posterior fracture-dislocation of the shoulder is very rare and can be caused by epileptic seizures, trauma, electrocution or electroconvulsive therapy.Case presentationA 62-year-old Sri Lankan male was admitted to our medical unit following four repeated generalized tonic–clonic convulsions, each lasting for several minutes. Following the second seizure he reported an inability to move both upper arms due to intense pain. There was no history of fall during the episodes of convulsions however but the bystanders have forcibly restrained his movements during the tonic–clonic convulsions. Clinical examination revealed severely restricted range of movement in both shoulders, with associated swelling and bruising of the shoulder joints and upper arms. Radiographs of the shoulders confirmed fractures at the level of surgical neck with posterior dislocation.ConclusionBilateral posterior fracture-dislocation of shoulders complicating epileptic seizures are rare. Forcible restraining of the patient’s upper limbs during seizures is the likely cause for the fracture dislocations in our patient and this had not been reported before.

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Bilateral posterior four-part fracture–dislocations of the shoulders following electric shock

Cited by 17 publications

References 15 publications

Bilateral posterior fracture-dislocation of the shoulder: Report of two cases

Bilateral posterior fracture-dislocation of the shoulder: Report of two cases

Posterior four-part fracture-dislocations of the proximal humerus: clinical and functional evaluation of osteosynthesis treatment

Bilateral posterior fracture-dislocation of the shoulders following epileptic seizures: a case report and review of the literature

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