Kumar Yashavantha C, Nalini K B, Maini Lalit, Nagaraj Prashanth
MSR Medical College, Bangalore-560054, INDIA.
J Orthop Case Rep. 2013 Jan-Mar;3(1):23-5.
Bilateral shoulder dislocation are most commonly posterior type. These are most commonly due to seizure disorder and electrocution. Anterior shoulder dislocations occurring bilaterally without any predisposing factors are very rare. These types of injuries are due to trauma with a unique mechanism of injury. To best of our knowledge there are only few cases of similar kind are reported in literature. We hereby report a interesting case of posttraumatic, bilateral anterior dislocation of shoulder without associated fracture in a 45 old women without any predisposing pathoanatomy.
A 45-year-old women presented to casualty with sudden onset of pain and restriction of movement in both shoulders fallowing trauma. Immediately post trauma she had severe pain and restriction of both shoulders. On examination arms were abducted and externally rotated. Bilateral shoulder movements were painful and restricted. There was loss of round contour of shoulder with increased vertical diameter of axilla anteriorly. Radiological examination revealed bilateral anterior dislocation of the shoulders without any associated fractures. Closed reduction done by Milch technique after intraraticular lignocaine injection. MRI of bilateral shoulder showed no pathological lesion. Both shoulders were immobilized with a shoulder immobilizer for three weeks.
Most of the bilateral shoulder dislocations are posterior type seen in seizure disorders. Bilateral traumatic anterior shoulder dislocations are rare and are seen as a result of unique mechanism of injury. In our case patient had a fall on her elbows causing forced extension. If diagnosed and treated promptly completely normal function of the shoulders can be restored.
双侧肩关节脱位最常见为后脱位类型。其最常见病因是癫痫发作和触电。双侧无前驱因素的前肩关节脱位非常罕见。这类损伤是由具有独特损伤机制的创伤所致。据我们所知,文献中仅报道了少数几例类似病例。我们在此报告一例有趣的病例,一名45岁女性在无任何易患病理解剖因素的情况下,创伤后双侧肩关节前脱位且无相关骨折。
一名45岁女性因肩部创伤后突然出现疼痛和活动受限而就诊于急诊。创伤后即刻,她双肩剧痛且活动受限。检查时双臂外展并外旋。双侧肩部活动疼痛且受限。肩部失去圆润轮廓,腋窝前部垂直径增加。影像学检查显示双侧肩关节前脱位且无任何相关骨折。在关节内注射利多卡因后采用米尔奇技术进行闭合复位。双侧肩部MRI显示无病理性病变。双肩用肩部固定器固定三周。
大多数双侧肩关节脱位是癫痫发作时出现的后脱位类型。双侧创伤性前肩关节脱位罕见,是独特损伤机制的结果。在我们的病例中,患者肘部着地导致强迫伸展。如果及时诊断和治疗,肩部功能可完全恢复正常。