Bilateral posterior shoulder dislocation

Case contributed by Nicola Zelow

Presentation

Fall, shortness of breath with upper chest pain

Patient Data

Gender: Female

Initial imaging

X-ray

Minor central bronchial wall thickening and bronchial wall thickening in both lower zones. The remainder of the lungs and pleural spaces are clear with no focal areas of collapse or consolidation. The heart is normal in size.

Right shoulder x-ray

X-ray

Comminuted fracture of the humeral head extends from the greater tubercle to involve the anatomic neck with associated posterior dislocation of the glenohumeral joint.

Left shoulder x-ray

X-ray

Comminuted fracture of the humeral head extends from the greater tubercle with associated posterior dislocation of the glenohumeral joint.

Case Discussion

The posterior dislocation of both shoulders with associated comminuted fractures was not initially noted on the supine trauma film. The patient went on to have dedicated shoulder imaging where the fracture and dislocation was revealed, along with the extent of the injury. It was also later noted on the CT request form that the patient fell with possible seizure activity which provides a potential mechanism of injury for the posterior shoulder dislocations.

The patient underwent bilateral ORIF.

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