Simultaneous bilateral posterior fracture dislocation of the shoulders: A report of two cases

Background: Although anterior shoulder dislocations are common, posterior shoulder dislocations are rare, accounting for less than 5% of all shoulder dislocations. The diagnosis of posterior dislocations is often delayed due to their uncommon presentation. Simultaneous bilateral posterior shoulder d...

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Main Authors: Marcus Bianchi, Jorge Schreiner, Leonardo Comerlatto, Cristina Vicioli, Ramesses Akamefula, Márcio Ferrari
Format: Article
Language:English
Published: Kashan University of Medical Sciences 2025-08-01
Series:Archives of Trauma Research
Subjects:
Online Access:https://archtrauma.kaums.ac.ir/article_224068_ac970e542b525ecd61a56d1a0f5f721f.pdf
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author Marcus Bianchi
Jorge Schreiner
Leonardo Comerlatto
Cristina Vicioli
Ramesses Akamefula
Márcio Ferrari
author_facet Marcus Bianchi
Jorge Schreiner
Leonardo Comerlatto
Cristina Vicioli
Ramesses Akamefula
Márcio Ferrari
author_sort Marcus Bianchi
collection DOAJ
description Background: Although anterior shoulder dislocations are common, posterior shoulder dislocations are rare, accounting for less than 5% of all shoulder dislocations. The diagnosis of posterior dislocations is often delayed due to their uncommon presentation. Simultaneous bilateral posterior shoulder dislocations are extremely rare and are usually associated with seizures or electroconvulsive therapy. This article presents two cases of bilateral simultaneous posterior shoulder dislocations, one resulting from a seizure and the other from an electric shock.Case presentation: Case 1: A 68-year-old woman was admitted to the orthopedic emergency center after experiencing an electric shock at home. She presented with pain and an inability to mobilize her shoulders. On physical examination, the extremities were well perfused; however, there were marked bilateral limitations in shoulder elevation, abduction, external rotation, and internal rotation. X-rays and a Computed Tomography (CT) scan were performed, and the patient underwent surgery, consisting of reduction and fixation of the humeral head with a Kirschner wire, along with suturing of the humeral bone fragments. An engaging reverse Hill-Sachs lesion was identified and treated by transposition of the subscapularis tendon to fill the resultant defect. Case 2: A 68-year-old man was admitted to the orthopedic trauma center with pain and functional limitations in both shoulders. His symptoms began seven days earlier following a fall at home, during which he lost consciousness. X-rays and a CT scan confirmed the diagnosis of bilateral posterior shoulder dislocation. After a cardiologic evaluation, the surgical procedure involved reducing and disimpacting the humeral heads through a deltopectoral approach, followed by transferring the subscapularis tendon to the humeral head bone defect.Discussion: Although uncommon, prompt and accurate diagnosis of bilateral posterior shoulder dislocation, along with appropriate treatment, is essential to prevent disabling sequelae in affected patients.
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spelling doaj-art-4477ce2c1eb045b68ff7665f5a8598412025-08-20T03:44:02ZengKashan University of Medical SciencesArchives of Trauma Research2251-953X2251-95992025-08-0114212012410.48307/atr.2025.508080.1209224068Simultaneous bilateral posterior fracture dislocation of the shoulders: A report of two casesMarcus Bianchi0Jorge Schreiner1Leonardo Comerlatto2Cristina Vicioli3Ramesses Akamefula4Márcio Ferrari5Hospital Cristo Redentor, Porto Alegre, RS, BrazilHospital Cristo Redentor, Porto Alegre, RS, BrazilHospital Cristo Redentor, Porto Alegre, RS, BrazilSanta Casa de Misericordia de Porto Alegre, Porto Alegre, RS, BrazilTulane University School of Medicine, New Orleans, LA, USAHospital de Clínicas de Porto Alegre, Porto Alegre, BrazilBackground: Although anterior shoulder dislocations are common, posterior shoulder dislocations are rare, accounting for less than 5% of all shoulder dislocations. The diagnosis of posterior dislocations is often delayed due to their uncommon presentation. Simultaneous bilateral posterior shoulder dislocations are extremely rare and are usually associated with seizures or electroconvulsive therapy. This article presents two cases of bilateral simultaneous posterior shoulder dislocations, one resulting from a seizure and the other from an electric shock.Case presentation: Case 1: A 68-year-old woman was admitted to the orthopedic emergency center after experiencing an electric shock at home. She presented with pain and an inability to mobilize her shoulders. On physical examination, the extremities were well perfused; however, there were marked bilateral limitations in shoulder elevation, abduction, external rotation, and internal rotation. X-rays and a Computed Tomography (CT) scan were performed, and the patient underwent surgery, consisting of reduction and fixation of the humeral head with a Kirschner wire, along with suturing of the humeral bone fragments. An engaging reverse Hill-Sachs lesion was identified and treated by transposition of the subscapularis tendon to fill the resultant defect. Case 2: A 68-year-old man was admitted to the orthopedic trauma center with pain and functional limitations in both shoulders. His symptoms began seven days earlier following a fall at home, during which he lost consciousness. X-rays and a CT scan confirmed the diagnosis of bilateral posterior shoulder dislocation. After a cardiologic evaluation, the surgical procedure involved reducing and disimpacting the humeral heads through a deltopectoral approach, followed by transferring the subscapularis tendon to the humeral head bone defect.Discussion: Although uncommon, prompt and accurate diagnosis of bilateral posterior shoulder dislocation, along with appropriate treatment, is essential to prevent disabling sequelae in affected patients.https://archtrauma.kaums.ac.ir/article_224068_ac970e542b525ecd61a56d1a0f5f721f.pdfposterior shoulder dislocationshoulder instabilityreverse hill-sachs lesion
spellingShingle Marcus Bianchi
Jorge Schreiner
Leonardo Comerlatto
Cristina Vicioli
Ramesses Akamefula
Márcio Ferrari
Simultaneous bilateral posterior fracture dislocation of the shoulders: A report of two cases
Archives of Trauma Research
posterior shoulder dislocation
shoulder instability
reverse hill-sachs lesion
title Simultaneous bilateral posterior fracture dislocation of the shoulders: A report of two cases
title_full Simultaneous bilateral posterior fracture dislocation of the shoulders: A report of two cases
title_fullStr Simultaneous bilateral posterior fracture dislocation of the shoulders: A report of two cases
title_full_unstemmed Simultaneous bilateral posterior fracture dislocation of the shoulders: A report of two cases
title_short Simultaneous bilateral posterior fracture dislocation of the shoulders: A report of two cases
title_sort simultaneous bilateral posterior fracture dislocation of the shoulders a report of two cases
topic posterior shoulder dislocation
shoulder instability
reverse hill-sachs lesion
url https://archtrauma.kaums.ac.ir/article_224068_ac970e542b525ecd61a56d1a0f5f721f.pdf
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AT leonardocomerlatto simultaneousbilateralposteriorfracturedislocationoftheshouldersareportoftwocases
AT cristinavicioli simultaneousbilateralposteriorfracturedislocationoftheshouldersareportoftwocases
AT ramessesakamefula simultaneousbilateralposteriorfracturedislocationoftheshouldersareportoftwocases
AT marcioferrari simultaneousbilateralposteriorfracturedislocationoftheshouldersareportoftwocases