Bilateral Posterior Four-Part Fracture-Dislocation of the Proximal Humerus After First-Time Seizure.

This report presents a previously undescribed case and treatment of bilateral four-part proximal humerus (PH) fracture-dislocations presented in a 61-year-old Caucasian male patient following a first-time seizure episode. The patient was treated with bilateral reverse total shoulder arthroplasty due to pre-existing glenohumeral arthritis and rotator cuff atrophy. The surgery was successful, and the patient's postoperative recovery was uneventful. Fractures of the proximal humerus are a relatively common adult osteoporotic fracture; however, posterior fracture-dislocations of the PH, frequently related to motor vehicle accidents, seizures, or electrical shock, are remarkably scarce. A treatment algorithm for these injuries is lacking.