Ketenci Ismail Emre, Duymus Tahir Mutlu, Ulusoy Ayhan, Yanik Hakan Serhat, Mutlu Serhat, Durakbasa Mehmet Oguz
Department of Orthopaedics, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.
Department of Orthopaedics, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey.
Ann Med Surg (Lond). 2015 Nov 4;4(4):417-21. doi: 10.1016/j.amsu.2015.10.010. eCollection 2015 Dec.
Posterior dislocation of the shoulder is a rare and commonly missed injury. Unilateral dislocations occur mostly due to trauma. Bilateral posterior shoulder dislocations are even more rare and result mainly from epileptic seizures. Electrical injury is a rare cause of posterior shoulder dislocation. Injury mechanism in electrical injury is similar to epileptic seizures, where the shoulder is forced to internal rotation, flexion and adduction.
This report presents a case of bilateral posterior shoulder dislocation after electrical shock. We were able to find a few individual case reports describing this condition. The case was acute and humeral head impression defects were minor. Our treatment in this case consisted of closed reduction under general anesthesia and applying of orthoses which kept the shoulders in abduction and external rotation. A rehabilitation program was begun after 3 weeks of immobilization. After 6 months of injury the patient has returned to work. 20 months postoperatively, at final follow-up, he was painless and capable of performing all of his daily activities.
The amount of bilateral shoulder dislocations after electrical injury is not reported but is known to be very rare. The aim of this case presentation is to report an example for this rare entity, highlight the difficulties in diagnosis and review the treatment options.
Physical examination and radiographic evaluation are important for quick and accurate diagnosis.
肩关节后脱位是一种罕见且常被漏诊的损伤。单侧脱位大多由外伤引起。双侧肩关节后脱位更为罕见，主要由癫痫发作导致。电击伤是肩关节后脱位的罕见原因。电击伤的损伤机制与癫痫发作相似，即肩部被迫内旋、屈曲和内收。
本报告呈现了一例电击伤后双侧肩关节后脱位的病例。我们仅能找到少数描述这种情况的个别病例报告。该病例为急性，肱骨头压痕缺损较小。我们对该病例的治疗包括在全身麻醉下进行闭合复位，并应用矫形器使肩部保持外展和外旋。固定3周后开始康复计划。受伤6个月后患者恢复工作。术后20个月，在最后一次随访时，他无痛且能够进行所有日常活动。
电击伤后双侧肩关节脱位的数量尚无报道，但已知非常罕见。本病例报告的目的是报告这一罕见病例，强调诊断中的困难并回顾治疗选择。
体格检查和影像学评估对于快速准确的诊断很重要。
