Skip to main content
SpringerLink
Log in

Traumatic bilateral posterior dislocation of the shoulder: a case report

  • Case Report
  • Published:
Central European Journal of Medicine

Abstract

Introduction. Bilateral posterior dislocation of the shoulder is a rare injury, accounted for about 2–5% of all shoulder dislocations. Main courses are electrical shock, epilepsy or extreme trauma with uncontrolled muscle forces. We report about a case of bilateral posterior shoulder dislocation without additional fractures but with a concomitant acromioclavicular joint dislocation. Case presentation. A 46-year-old Caucasian motorcyclist presented to our facility after a fall on slippery ground. He claimed pain in both shoulders with limited range of motion. The initial X-rays were inconclusive, clinical examination showed typical findings of a Rockwood injury with an additional limited external rotation so that a posterior shoulder dislocation was suspected. The CT scan confirmed the clinical suspicion. A closed reduction was performed followed by immobilization in a shoulder abduction pillow for 4 weeks and continuous physiotherapy. Upon follow up normal function with full range of motion was observed. Conclusion. A bilateral posterior shoulder dislocation can be caused by trauma and results in a limited range of motion with often additional injuries. Due to the unusually presentation the risk of missing the injury is increased. Therefore it is most important to consider this rare diagnosis and in case of clinical suspicion perform a careful algorithm of diagnostic.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Alta TDW, Willems WJ. Bilateral posterior fracturedislocation of the shoulder managed by allograft reconstruction of the segmental defect: report of two cases. European Journal of Orthopaedic Surgery and Traumatology. 2008;18(5):381–385

    Article  Google Scholar 

  2. Aparicio G, Calvo E, Bonilla L, Espejo L, Box R. Neglected traumatic posterior dislocations of the shoulder: controversies on indications for treatment and new CT scan findings. Journal of Orthopaedic Science. 2000;5(1):37–42

    Article  PubMed  CAS  Google Scholar 

  3. Arndt JH, Sears AD. Posterior dislocation of the shoulder. Am J Roentgenol Radium Ther Nucl Med 1965;94:639–645

    PubMed  CAS  Google Scholar 

  4. Betz ME, Traub SJ. Bilateral posterior shoulder dislocations following seizure. Internal and Emergency Medicine. 2007;2(1):63–65

    Article  PubMed  CAS  Google Scholar 

  5. Castagna A, Delle Rose G, Borroni M, Markopoulos N, Conti M, Maradei L, Garofalo R. Modified MacLaughlin procedure in the treatment of neglected posterior dislocation of the shoulder. Chir Organi Mov. 2009 Apr;93Suppl 1:S1–5

    PubMed  Google Scholar 

  6. Cicak N. Posterior dislocation of the shoulder. Journal of Bone and Joint Surgery-Series B. 2004;86(3):324–332

    Article  CAS  Google Scholar 

  7. Cisternino SJ, Rogers LF et al. The trough line: a radiographic sign of posterior shoulder dislocation. Am J Roentgenol. 1978;130(5):951–954

    Article  CAS  Google Scholar 

  8. Delcogliano A, Caporaso A, Chiossi S, Menghi A, Cillo M, Delcogliano M. Surgical management of chronic unreduced posterior dilocation of the shoulder. Knee Surg Sports Traumatol Arthrosc. 2005;13:151–155

    Article  PubMed  CAS  Google Scholar 

  9. Dimon JH III. Posterior dislocation and posterior fracture dislocation of the shoulder: a report of 25 cases. South Med J. 1967;60(6):661–666

    Article  PubMed  Google Scholar 

  10. Hawkins RJ. Unrecognized dislocations of the shoulder. Instr Course (1985)

    Google Scholar 

  11. Hawkins RJ, Neer CS, Pianta RM, Mendoza FX. Locked posterior dislocation of the shoulder. Journal of Bone and Joint Surgery—Series A. 1987;69(1):9–18

    CAS  Google Scholar 

  12. Hsu CJ, Hsu HC, Fong YC, Kuo CC, Wang DY. Bilateral locked posterior fracture-dislocation of the shoulders due to electric shock. Mid-Taiwan Journal of Medicine. 2006;11(2):132–137

    Google Scholar 

  13. Iosifidis MI, Giannoulis I, Traios S, Giantsis G. Simultaneous bilateral posterior dislocation of the shoulder: diagnostic problems and management—a case report. Knee Surgery, Sports Traumatology, Arthroscopy. 2006;14(8):766–770

    Article  PubMed  Google Scholar 

  14. Ivkovic A, Boric I, Cicak N. One-stage operation for locked bilateral posterior dislocation of the shoulder. Journal of Bone and Joint Surgery—Series B. 2007;89(6):825–828

    Article  CAS  Google Scholar 

  15. Kirchhoff C, Braunstein V, Buhmann S, Kanz KG, Mutschler W, Biberthaler P. Traumatic posterior shoulder dislocation: diagnosis and therapy. Unfallchirurg. 2007 Dec;110(12):1059–1064

    Article  PubMed  CAS  Google Scholar 

  16. Kokkalis ZT, Mavrogenis AF, Ballas EG, Papagelopoulos PJ, Zoubos AB. Bilateral neglected posterior fracture-dislocation of the shoulders. Orthopedics. 2012 Oct;35(10):e1537–1541

    Article  PubMed  Google Scholar 

  17. Kwon YW, Kulwicki KJ, Zuckerman JD. Glenohumeral joint sublaxation, dislocation, and instability. In: Bucholz RW, Court-Brown CM, Heckman JD, Tornetta P, editors. Rockwood and Green’s Fractures in Adults. Philadelphia, Pa, USA: Lippincott Williams & Wilkins; 2010. pp. 1165–1209

    Google Scholar 

  18. Meshdagh H, Maynou C, Delobelle JM et al. Traumatic posterior dislocation of the shoulder in adults. Apropos of 25 cases. Ann Chir 1994;48:355–363

    Google Scholar 

  19. Mnif H, Koubaa M, Zrig M, Zrour S, Amara K, Bergaoui N, Abid A. Bilateral posterior fracture dislocation of the shoulder. Chir Main. 2010 Apr;29(2):132–134

    Article  PubMed  CAS  Google Scholar 

  20. Mouzopoulos G. The “Mouzopoulos” sign: a radiographic sign of posterior shoulder dislocation. Emergency Radiology. 2010;17(4):317–320

    Article  PubMed  Google Scholar 

  21. Randelli M, Gambrioli PL. Chronic posterior dislocation of the shoulder. Surgical techniques in orthopaedics traumatology. 2001;55-190-B-10. Elsevier, Paris

    Google Scholar 

  22. Rezazadeh S, Vosoughi AR. Closed reduction of bilateral posterior shoulder dislocation with medium impression defect of the humeral head: a case report and review of its treatment. Case Rep Med. 2011;2011:124581

    PubMed  Google Scholar 

  23. Rockwood C. The diagnosis of acute posterior dislocation of the shoulder. J Bone Joint Surg Am 1965;46:1220

    Google Scholar 

  24. Schliemann B, Muder D, Gessmann J, Schildhauer TA, Seybold D. Locked posterior shoulder dislocation: treatment options and clinical outcomes. Arch Orthop Trauma Surg. 2011 Aug;131(8):1127–1134

    Article  PubMed  Google Scholar 

  25. Walch G, Boileau P, Martin B, Dejour H. Unreduced posterior luxations and fractures-luxations of the shoulder. Apropos of 30 cases. Revue de Chirurgie Orthopedique et Reparatrice de l’Appareil Moteur. 1990;76(8):546–558

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Universitätsklinikum Aachen, Aachen, Germany

    C. Garving, T. Dienstknecht, K. Horst, M. Pishnamaz, P. Kobbe & H. -C. Pape

Authors
  1. C. Garving
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. T. Dienstknecht
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. K. Horst
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. Pishnamaz
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. P. Kobbe
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. H. -C. Pape
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to C. Garving.

About this article

Cite this article

Garving, C., Dienstknecht, T., Horst, K. et al. Traumatic bilateral posterior dislocation of the shoulder: a case report. cent.eur.j.med 8, 810–813 (2013). https://doi.org/10.2478/s11536-013-0228-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2478/s11536-013-0228-8

Keywords

Search

Navigation