Chronic Bilateral Locked Anterior Shoulder Fracture-Dislocations

Abstract not available. Introduction provided instead.

Bilateral shoulder dislocations of the humeral head are uncommon injuries. Although they typically result from an awkward fall or trauma,^1-15 bilateral
anterior dislocations can also be associated with systemic injuries such as seizure,^2,5,16-23 electrocution,^24-26 and hypoglycemia.^27,28 Even more infrequently
reported are bilateral shoulder fracture-dislocations (Table).^{2,4,10,11,15,18,19,22,24,25,27,29-31}

When a systemic insult, such as a seizure, causes bilateral dislocations of the glenohumeral joint, the diagnosis of a musculoskeletal injury can be delayed, as treatment of the overlying condition is given priority. Historically, many terms have been used to characterize delayed presentation of a shoulder dislocation: missed,³⁰ undiagnosed,¹ unrecognized,³² unreduced,³³ neglected,³⁴ old,⁴ locked,³⁵ and chronic.³⁶ In their case series of shoulder dislocations with delayed presentation, Rowe and Zarins³⁷ considered any dislocation with a reduction delay of at least 3 weeks to be chronic.

In the present report, we use such a delay to define chronic, bilateral, locked, anterior shoulder dislocations with bilateral greater tuberosity fractures. To our knowledge, this is the first reported case of bilateral open reduction and
internal fixation (ORIF) for such an injury.