Bilateral anterior shoulder dislocation
A 24-year-old man presented to accident and emergency department with complaints of acute shoulder pain involving both shoulders after trying to prevent a fall. He tried to prevent falling backward by extending both arms behind his back. He had no history of seizure, alcohol intake or previous shoulder dislocation. Both shoulders were abducted and externally rotated. Physical examination showed fullness over anterior aspect and bilateral squaring of his shoulders (epaulet sign). Both humeral heads were palpated in the anterior aspect of each joint and there was a global, painful restriction of range of motion in both shoulders, without any evidence of peripheral motor, sensory and vascular deficit.\nA clinical diagnosis of bilateral anterior shoulder dislocations with no neurovascular deficit was made. There was no evidence of any generalised ligamentous laxity. Radiographs confirmed bilateral anterior glenohumeral dislocation with greater tuberosity fracture on left side []. Both shoulders were reduced using Kocher's technique under sedation. Reduction of both shoulders was obtained which was confirmed radiologically [Figure and ]. Since the greater tuberosity fracture of left shoulder returned to its anatomical position after reduction, so it was decided to manage the fracture conservatively. Both arms continued to be neurvascularily intact and were armpouch in slings. Right shoulder was immobilized for one week and left shoulder for six weeks.\nThe patient received physical therapy as tolerated and no further episodes of instability ensued. At follow-up of two months the patient reported no pain and had returned to his normal activities of daily living with minimal discomfort. Both shoulders had near normal range of motion with pain only present at the extremes of motion. Both shoulders also had negative apprehension tests. Power was 5/5 in both shoulders. Radiographs showed an anatomical consolidation of greater tuberosity fracture of left shoulder joint. At the end of one year follow up, the fracture has united with no restriction of motion and the shoulders were defined as stable.