Patil Mallanagouda N
BIMS, Belgaum, Karnataka, India.
J Orthop Case Rep. 2013 Apr-Jun;3(2):35-7. doi: 10.13107/jocr.2250-0685.100.
Anterior dislocation of shoulder is commonest dislocation one encounters in day to day Orthopaedic practice. But bilateral shoulder dislocations are relatively uncommon frequently posterior and secondary to violent muscle contraction. Simultaneous bilateral anterior dislocations of shoulder following trauma is rare occurrence.
35 year old male presented to emergency department with history fall by tripping on a stone (fall on outstretched hand). He complained of pain and difficulty in moving both the shoulders. On clinical examination, patient's both upper limbs were abducted and externally rotated. Bilaterally shoulder contour was lost with flattening. Other classical signs of shoulder dislocation viz, Bryants test, Callway sign, Hamilton's ruler test were positive. Diagnosis was confirmed on X rays. Both shoulders were reduced in emergency operation theater under general anaesthesia by Kocher's method and were immobilised in sling.
Though bilateral shoulder dislocations are commonly posterior, usually either secondary to convulsions or electric shock, anterior dislocation has to be kept in mind , especially in post traumatic injuries. This bilateral dislocation also presents with practical problems immobilization and day to day care of patients.
肩关节前脱位是日常骨科实践中最常见的脱位类型。但双侧肩关节脱位相对少见,且多为后脱位,继发于剧烈肌肉收缩。创伤后双侧肩关节同时发生前脱位则更为罕见。
一名35岁男性因绊倒在石头上(伸手撑地摔倒)被送往急诊科。他主诉双肩疼痛且活动困难。临床检查时,患者双上肢外展并外旋。双侧肩部轮廓消失且变平。其他肩关节脱位的典型体征,如布莱恩特试验、卡尔韦征、汉密尔顿直尺试验均为阳性。X线检查确诊。在全身麻醉下于急诊手术室采用科赫法对双侧肩关节进行复位,并使用吊带固定。
虽然双侧肩关节脱位通常为后脱位,多继发于抽搐或电击,但也必须考虑前脱位的情况,尤其是在创伤后损伤中。这种双侧脱位在患者固定和日常护理方面也存在实际问题。