Auerbach Brett, Bitterman Adam, Mathew Cristin, Healy William
J Am Osteopath Assoc. 2015 Aug;115(8):514-7. doi: 10.7556/jaoa.2015.106.
Shoulder dislocations are a common condition seen by orthopedic surgeons and emergency medicine physicians. Shoulder dislocations typically present unilaterally and are anterior in nature. Bilateral simultaneous posterior shoulder dislocations are typically associated with seizure or electrocution and are more common than bilateral simultaneous anterior dislocations, which occur because of trauma or fall. In a traumatic setting, a shoulder dislocation may be accompanied by a distracting injury, and a thorough examination must be conducted to avoid overlooking concomitant diagnosis. The authors highlight the case of a patient who presented to the emergency department with the rare incidence of traumatic bilateral anterior shoulder dislocations, which resolved after 2 closed reductions. Orthopedic surgery and emergency medicine teams must maintain a high index of suspicion for injury to the contralateral limb to avoid missing pathologic changes due to distracting injuries.
肩关节脱位是骨科医生和急诊医学医生常见的病症。肩关节脱位通常单侧发生,且多为前脱位。双侧同时发生的后肩关节脱位通常与癫痫发作或触电有关,比双侧同时发生的前脱位更常见,后者多因外伤或跌倒所致。在创伤情况下,肩关节脱位可能伴有其他分散注意力的损伤,必须进行全面检查以避免漏诊其他合并症。作者强调了一例患者,该患者因罕见的创伤性双侧前肩关节脱位到急诊科就诊,经两次闭合复位后痊愈。骨科手术团队和急诊医学团队必须对侧肢体损伤保持高度怀疑指数,以避免因分散注意力的损伤而漏诊病理变化。