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Neglected Bilateral Posterior Shoulder Fracture Dislocation in an Uncontrolled Seizure patient.

Amir MA, Alenazi B, Wyse RK, Tamimi W, Kujan O, Khan T, Alenzi FQ - Pak J Med Sci (2015 Jul-Aug)

Bottom Line: Diagnosis is often missed and treatment is challenging.Correct diagnosis is achieved by history taking, a physical examination and appropriate imaging.In neglected shoulder dislocation with uncontrolled seizure and humeral head defects of up to 45% the McLaughlin procedure shows excellent results at follow-up.

View Article: PubMed Central - PubMed

Affiliation: Moaath A. Amir, Department of Orthopedics, Military Hospital, Riyadh, Saudi Arabia.

ABSTRACT
Posterior dislocation of the shoulder is a rare injury that occurs secondary to trauma and seizures. Diagnosis is often missed and treatment is challenging. Neglected posterior dislocation is associated with Hill-Sachs lesion which leads to locking of dislocation. Correct diagnosis is achieved by history taking, a physical examination and appropriate imaging. In neglected shoulder dislocation with uncontrolled seizure and humeral head defects of up to 45% the McLaughlin procedure shows excellent results at follow-up.

No MeSH data available.


Related in: MedlinePlus

Axial C. T. shows humeral head defect.
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Figure 4: Axial C. T. shows humeral head defect.

Mentions: Six months later the patient had another seizure which resulted, this time, in a left posterior shoulder fracture dislocation, and was diagnosed and treated in another hospital with close reduction. Due to patient non-compliance to their follow ups and their treatment for epilepsy, the patient had multiple seizures. One month later the patient presented in our ER with left shoulder pain and decreased left shoulder external rotation. X-rays of AP and axillary view (Fig.2a) were conducted which showed left posterior locked fracture dislocation of the humeral head and a CT scan (Fig.2b) showed a 40% humeral head defect reverse Hill-Sachs lesion. The patient underwent a left shoulder McLaughlin procedure and shoulder Spica in external rotation followed by passive, then active-assisted, and active range of motion and rotator cuff strengthening exercises.


Neglected Bilateral Posterior Shoulder Fracture Dislocation in an Uncontrolled Seizure patient.

Amir MA, Alenazi B, Wyse RK, Tamimi W, Kujan O, Khan T, Alenzi FQ - Pak J Med Sci (2015 Jul-Aug)

Axial C. T. shows humeral head defect.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4590399&req=5

Figure 4: Axial C. T. shows humeral head defect.
Mentions: Six months later the patient had another seizure which resulted, this time, in a left posterior shoulder fracture dislocation, and was diagnosed and treated in another hospital with close reduction. Due to patient non-compliance to their follow ups and their treatment for epilepsy, the patient had multiple seizures. One month later the patient presented in our ER with left shoulder pain and decreased left shoulder external rotation. X-rays of AP and axillary view (Fig.2a) were conducted which showed left posterior locked fracture dislocation of the humeral head and a CT scan (Fig.2b) showed a 40% humeral head defect reverse Hill-Sachs lesion. The patient underwent a left shoulder McLaughlin procedure and shoulder Spica in external rotation followed by passive, then active-assisted, and active range of motion and rotator cuff strengthening exercises.

Bottom Line: Diagnosis is often missed and treatment is challenging.Correct diagnosis is achieved by history taking, a physical examination and appropriate imaging.In neglected shoulder dislocation with uncontrolled seizure and humeral head defects of up to 45% the McLaughlin procedure shows excellent results at follow-up.

View Article: PubMed Central - PubMed

Affiliation: Moaath A. Amir, Department of Orthopedics, Military Hospital, Riyadh, Saudi Arabia.

ABSTRACT
Posterior dislocation of the shoulder is a rare injury that occurs secondary to trauma and seizures. Diagnosis is often missed and treatment is challenging. Neglected posterior dislocation is associated with Hill-Sachs lesion which leads to locking of dislocation. Correct diagnosis is achieved by history taking, a physical examination and appropriate imaging. In neglected shoulder dislocation with uncontrolled seizure and humeral head defects of up to 45% the McLaughlin procedure shows excellent results at follow-up.

No MeSH data available.


Related in: MedlinePlus