Kambhampati Srinivas B S, Saseendar Samundeeswari, Shanmugasundaram Saseendar
Department of Orthopaedics, "Sri Dhaatri," SKDGOC, Vijayawada, Andhra Pradesh, India.
Department of Orthopaedics, CARE Sports Injury, Chennai, India.
J Orthop Case Rep. 2020 Sep;10(6):80-85. doi: 10.13107/jocr.2020.v10.i06.1886.
Bilateral shoulder dislocations are rare and can result from sports injuries, epileptic seizures, electric shock, or electroconvulsive therapy. Divergent shoulder dislocations are even more rare and difficult to treat. We report a case of bilateral divergent shoulder dislocations with bilateral greater tuberosity fractures. We have reviewed the existing literature and have summarized the mechanisms and outcomes of such injuries.
A 35-year-old, right-hand dominant male, a known epileptic presented with pain and deformity in both shoulders after an episode of generalized seizures. Radiographs revealed anterior dislocation on the right and posterior dislocation on the left shoulders along with bilateral displaced fractures of the greater tuberosities. The patient was treated with closed reduction of bilateral shoulder dislocations using gentle traction followed by open suture fixation of the greater tuberosity fractures. The greater tuberosity on the posterior dislocation side needed redo fixation with compression screws and sutures for failed fixation. The patient went on to heal well and achieve full function. The case is one of a very rare group of injuries.
Divergent shoulder injuries with greater tuberosity fractures are very rare. They can present a diagnostic and therapeutic challenge. A higher degree of suspicion to diagnose and patient-based approach with strong fixation techniques can lead to good clinical outcomes.
双侧肩关节脱位较为罕见，可由运动损伤、癫痫发作、电击或电休克治疗引起。分离性肩关节脱位更为罕见且治疗困难。我们报告一例双侧分离性肩关节脱位合并双侧大结节骨折的病例。我们回顾了现有文献并总结了此类损伤的机制和治疗结果。
一名35岁、惯用右手的男性癫痫患者，在一次全身性癫痫发作后出现双肩疼痛和畸形。X线片显示右肩关节前脱位，左肩关节后脱位，同时双侧大结节骨折移位。患者接受了双侧肩关节脱位的闭合复位，采用轻柔牵引，随后对大结节骨折进行切开缝合固定。后脱位侧的大结节因固定失败需要用加压螺钉和缝线重新固定。患者恢复良好，功能完全恢复。该病例属于非常罕见的损伤类型之一。
合并大结节骨折的分离性肩部损伤非常罕见。它们可能带来诊断和治疗挑战。提高诊断的怀疑度并采用基于患者的方法以及强大的固定技术可带来良好的临床结果。
