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Simultane bilaterale vordere und hintere Schulterluxation nach epileptischem Anfall—eine seltene Verletzungskombination

Simultaneous bilateral ventral and dorsal shoulder dislocation following an epileptic convulsion—a rare combination of injuries

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Zusammenfassung

Wir berichten über einen 29-jährigen Patienten, der sich im Rahmen der Erstmanifestation eines Krampfleidens eine simultane bilaterale ventrale und dorsale Schulterluxation zuzog. Rechts kam es nach geschlossenem Repositionsmanöver zu einer Luxationsfraktur, die am Unfalltag offen reponiert und winkelstabil versorgt wurde. Die verhakte dorsale Schulterluxation links wurde zweizeitig von dorsal reponiert und der Kalottendefekt bildwandlergestützt geschlossen angehoben.

6 Monate postoperativ war der Patient beschwerdefrei bei unbehinderter Beweglichkeit links und geringem Abduktions- und Anteversionsdefizit rechts.

Die Diagnostik und die Behandlungsstrategie der beschriebenen seltenen Verletzungskombination werden kritisch dargestellt.

Abstract

We report about a 29 year old male patient who had a simultaneous bilateral ventral and dorsal shoulder dislocation. The dislocation happened during a first incident of an epileptic convulsion, previously not diagnosed.

On the right shoulder following a closed reduction manoeuvre a dislocation fracture was seen. It needed operative open reduction and fixation with angular stable plate osteosynthesis. The locked dorsal shoulder dislocation on the left was operated dorsally secondary via a dorsal approach. In a first step the reduction was carried out and in the same intervention the humeral head defect was lifted and supported in a closed technique under radiographic control.

6 months postoperatively the patient was free of pain in both shoulder joints. The range of motion was unimpeded on the left and only with slight deficits in abduction and anteversion on the right. The diagnostics and the treatment strategy for this rare injury combination are described critically in this paper.

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  1. Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Klinikum Dresden

    R. Cyffka, Th. Jackisch, Th. Lein & F. Bonnaire

  2. Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Friedrichstraße 41, 01067, Dresden

    R. Cyffka

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  1. R. Cyffka
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  2. Th. Jackisch
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Correspondence to R. Cyffka.

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Cyffka, R., Jackisch, T., Lein, T. et al. Simultane bilaterale vordere und hintere Schulterluxation nach epileptischem Anfall—eine seltene Verletzungskombination. Unfallchirurg 108, 327–331 (2005). https://doi.org/10.1007/s00113-004-0878-8

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