Case Report: Bilateral Anterior Glenohumeral Dislocations

Case Report

Austin Orthop. 2016; 1(1): 1001.

Case Report: Bilateral Anterior Glenohumeral Dislocations

Vishal Mehta*, Franklin Lee, Milap Patel and Gus Katsigiorgis

Department of Orthopedic Surgery, Northwell Health - Plainview Hospital, USA

*Corresponding author: Vishal Mehta, Department of Orthopedic Surgery, Northwell Health - Plainview Hospital, New York 11803, USA

Received: November 27, 2015; Accepted: January 11, 2016; Published: January 12, 2016


Bilateral Glenohumeral dislocations are rare in nature. The simultaneous force necessary to dislocate both shoulders is very uncommon and not well represented in literature. The majority of bilateral shoulder dislocations are posterior and most often due to seizure activity or electric shock. We discuss a unique case with an unusual mechanism of bilateral anterior shoulder dislocation. The patient did not have any fractures that are common with bilateral anterior shoulder dislocations. Both shoulders were ultimately reduced in the emergency department using the Milch shoulder reduction technique.

Keywords: Bilateral shoulder dislocation; Milch technique; Anterior shoulder dislocation


The Glenohumeral joint is the most mobile major joint in the human body. While it has superior mobility compared to other joints, it sacrifices stability. Thus, the shoulder is one of the most commonly dislocated joints that present to the Emergency Department. Over 95% of shoulder dislocations are anterior in nature [1]. The remaining shoulder dislocations are posterior and thought to be pathognomonic for seizure activity or electric shock injuries.

The mechanism of dislocation are very different between anterior versus posterior dislocations of the shoulder. Posterior dislocations are due to muscle contraction secondary to electrical impulses [2]. Anterior dislocations are due to a posterior force on the arm while in external rotation and abduction. This force levers the head of the humerus out of the glenoid socket and can avulse the anteriorinferior labrum and/or bone causing a Bankart lesion [3].

In the case of bilateral shoulder dislocations, the most common are bilateral posterior dislocations. As with unilateral posterior shoulder dislocations, this is also due to seizure activity, extreme trauma, or electrocution [2, 4-6]. Bilateral anterior shoulder dislocations are rare entities due to a simultaneous force needed to dislocate both shoulders. Therefore, this case report presents an unusual mechanism of injury and one of the more rare orthopedic encounters in the emergency department.


A 66-year-old female presented to the emergency department of Franklin Hospital in Valley Stream, NY with bilateral shoulder pain and decreased range of motion on November 2015. The patient reports a trip and fall earlier in the day. She describes falling forward and attempting to brace her fall with both hands on the counter. The patient denies any previous shoulder dislocations or history of seizures.

On physical exam, the patient had anterior fullness of both shoulders with sulcus sign bilaterally. Passive range of motion was limited secondary to pain. The patient was neurovascularly intact. Pain was controlled at rest. There was no evidence of joint laxity at any other joints on secondary survey to indicate a predisposition for dislocation, such as those with Ehler-Danlos Syndrome.

Plain film radiography demonstrated bilateral anterior-inferior glenohumeral dislocations (Figure 1,2). There were no fractures associated with the dislocations. The patient denied having any prior dislocations in either shoulder.