Simultaneous bilateral posterior dislocation of the shoulder: diagnostic problems and management

Iosifidis, Michael; Giannoulis, Ioannis; Traios, S.; Giantsis, Georgios

doi:10.1007/s00167-006-0066-1

Cited by 15 publications

(12 citation statements)

References 26 publications

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“…22 Posterior shoulder dislocation is the most commonly missed major joint dislocation. 13 A reason for this may be found in the seemingly benign anterior posterior radiographic appearance. 1 Even after achieving the above mentioned position correctly, bony overlapping results in many cases.…”

Section: Discussionmentioning

confidence: 96%

The fulcrum axis: A new method for determining glenoid version

Braunstein

Körner

Brunner

et al. 2008

Journal of Shoulder and Elbow Surgery

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Section: Discussionmentioning

confidence: 96%

The fulcrum axis: A new method for determining glenoid version

Braunstein

Körner

Brunner

et al. 2008

Journal of Shoulder and Elbow Surgery

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“…Figure and Table summarize the study selection process. Five case reports were identified reporting fractures from GCSE, and 29 case reports, as well as five observational studies describing fractures from convulsive seizures (Table ). Of all 48 fractures described in detail in the literature as a direct consequence of convulsions, bilateral posterior fracture‐dislocations of the shoulders were reported most frequently (33%), followed by thoracic and lumbar vertebral compression fractures (29%), skull and jaw fractures (8%), and bilateral femoral neck fractures (6%) (Figure ; left).…”

Section: Systematic Review Of the Literaturementioning

confidence: 99%

Bone fractures from generalized convulsive seizures and status epilepticus—A systematic review

et al. 2019

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Objective We present a systematic review of the literature regarding types and anatomic distribution of fractures in association with generalized convulsive status epilepticus (GCSE) and convulsive seizures in adult patients accompanied by an illustrative case of a patient with GCSE and diffuse postictal pain from underlying bone fractures. Methods The library search engines PubMed and EMBASE were screened systematically using predefined search terms. All identified articles written in English were screened for eligibility by two reviewers. The preferred reporting items for systematic reviews and meta‐analyses guidelines were followed. Results The screening of 3145 articles revealed 39 articles meeting the inclusion criteria. Among all fractures, bilateral posterior fracture‐dislocations of the shoulders were reported most frequently (33%), followed by thoracic and lumbar vertebral compression fractures (29%), skull and jaw fractures (8%), and bilateral femoral neck fractures (6%). Risk factors for seizure‐related fractures are seizure severity, duration of epilepsy, the use of antiseizure drugs known to decrease bone density, and a family history of fractures. Based on these findings, a three‐step screening procedure is proposed to uncover fractures in the postictal state. All studies were retrospective without standardized screening methods for seizure‐associated fractures resulting in a very low level of evidence and a high risk of bias. Significance Posterior fracture‐dislocations of the shoulders, thoracic and lumbar vertebral compression, fractures of the skull and jaw, and bilateral femoral neck fractures are most frequently reported. Preventive measures including bone densitometry, calcium/vitamin D supplementation, and bisphosphonate therapy should be reinforced in epilepsy patients at risk of osteoporosis. As long as the effect of standardized screening of fractures is not investigated, it is too early to integrate such a screening into treatment guidelines. In the meantime, clinicians are urged to heighten awareness regarding seizure‐associated fractures, especially in patients with postictal pain, as symptoms can be unspecific and misinterpretation may impede rehabilitation.

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“…Posterior shoulder dislocation management depends on the patient´s age, duration of dislocation, extent of damage to articular surface and patient demands and level of activity [6,[12][13][14]17]. The time from the dislocation and the reverse Hill-Sachs lesion size are the major factors in determining whether or not close reduction can be used.…”

Section: Discussionmentioning

confidence: 99%

“…One way to help to confirm the diagnosis is the unique trauma mechanism: Traumatic posterior shoulder dislocations follow a specific injury mechanism with adduction and internal rotation in an outstretched anteflexed arm [10]. Dislocation duration and size of the humeral head defect are the major factors in determining the treatment plan [6,8,13,14]. Acute dislocation (less than six weeks of injury) and small defect up to 25% of the humeral head articular surface can be treated by closed or open reduction [6,13].…”

Section: Introductionmentioning

confidence: 99%

“…Dislocation duration and size of the humeral head defect are the major factors in determining the treatment plan [6,8,13,14]. Acute dislocation (less than six weeks of injury) and small defect up to 25% of the humeral head articular surface can be treated by closed or open reduction [6,13]. Therapy depends on clinical stability of the glenohumeral joint and associated injuries like the Hill-Sachs or Bankart-lesion.…”

Section: Introductionmentioning

confidence: 99%

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Traumatic bilateral posterior dislocation of the shoulder: a case report

et al. 2013

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AbstractIntroduction. Bilateral posterior dislocation of the shoulder is a rare injury, accounted for about 2–5% of all shoulder dislocations. Main courses are electrical shock, epilepsy or extreme trauma with uncontrolled muscle forces. We report about a case of bilateral posterior shoulder dislocation without additional fractures but with a concomitant acromioclavicular joint dislocation. Case presentation. A 46-year-old Caucasian motorcyclist presented to our facility after a fall on slippery ground. He claimed pain in both shoulders with limited range of motion. The initial X-rays were inconclusive, clinical examination showed typical findings of a Rockwood injury with an additional limited external rotation so that a posterior shoulder dislocation was suspected. The CT scan confirmed the clinical suspicion. A closed reduction was performed followed by immobilization in a shoulder abduction pillow for 4 weeks and continuous physiotherapy. Upon follow up normal function with full range of motion was observed. Conclusion. A bilateral posterior shoulder dislocation can be caused by trauma and results in a limited range of motion with often additional injuries. Due to the unusually presentation the risk of missing the injury is increased. Therefore it is most important to consider this rare diagnosis and in case of clinical suspicion perform a careful algorithm of diagnostic.

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Simultaneous bilateral posterior dislocation of the shoulder: diagnostic problems and management

Cited by 15 publications

References 26 publications

The fulcrum axis: A new method for determining glenoid version

The fulcrum axis: A new method for determining glenoid version

Bone fractures from generalized convulsive seizures and status epilepticus—A systematic review

Traumatic bilateral posterior dislocation of the shoulder: a case report

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