Bilateral Anterior Shoulder Dislocation with Bilateral Fractures of the Greater Tuberosity Following Electrocution: about a Rare Case and Review of the Literature

Case Report

Austin J Trauma Treat. 2019; 5(1): 1014.

Bilateral Anterior Shoulder Dislocation with Bilateral Fractures of the Greater Tuberosity Following Electrocution: about a Rare Case and Review of the Literature

Dehayni B¹*, Benchakroune M¹, Amarir M², Lamkhntar A¹, Ouazaa R¹, Tanane M¹ and Jaaraf A¹

¹Department of Traumatology Orthopedics Surgery I, University of Rabat, Morocco

²Department of Medical Imaging, University of Rabat, Morocco

*Corresponding author: Dehayni Badreddine, Department of Traumatology Orthopedics I, Mohamed V Military Hospital, Faculty of Medicine and Pharmacy, Mohamed V University, Rabat, Morocco

Received: January 17, 2019; Accepted: February 15, 2019; Published: February 22, 2019

Abstract

Bilateral anterior dislocation of the shoulders associated with a bilateral fracture of the greater tuberosity is an extremely rare lesion. We reported a case of bilateral dislocation of the shoulder following an electrocution received and operated on in the Traumatology Orthopaedics I department of the Mohamed V Military Training Hospital in Rabat. The diagnosis was clinical as confirmed by radiological investigations; the patient received surgical treatment after failure of orthopaedic treatment, a bloody reduction in dislocation and osteosynthesis of the greater tuberosity of both shoulders. An evolution was marked by a satisfactory functional recovery of both shoulders. Even clinical examination can help to suspect dislocation, but x-rays are mandatory for an accurate and early diagnosis. Surgery is recommended for unreduced dislocations or displaced fractures, orthopaedic treatment is indicated in non-displaced fractures subsequent functional rehabilitation allows results after surgical and non-surgical treatment

Keywords: Bilateral anterior dislocation of the shoulder; Fracture of the greater tuberosity; Electrocution; Surgical treatment

Introduction

Bilateral anterior dislocation of the shoulders associated with a bilateral fracture of the greater tuberosity is an extremely rare lesion. We report a case of bilateral anterior dislocation of the shoulder following an electrocution received and operated on in the Traumatology-Orthopaedics I department of the Mohamed V Military Training Hospital in Rabat.

Case Presentation

This is a 35-year-old patient, with no particular history, was admitted to the emergency department for a closed trauma of both shoulders with severe pain and total functional impotence following electrocution. He is a soldier who was the victim of an electric shock with a backward projection and a landing on both hands elbows in extension. The examination found bilateral bruises with signs of anterior dislocation of the shoulder, namely a sign of the shoulder, an external axe-blunt deformity and erasure of the deltopectoral furrows, pain on palpation of the shoulder stump (Figure 1). Sensitivity and motor skills in the territory of the axillary nerves were maintained and the bilateral radial pulse was present for both limbs. Shoulder x-rays supplemented by a 3D reconstruction CT scan confirmed the diagnosis of bilateral shoulder dislocation in its anterior subcoracoidal variety with bilateral displaced the greater tuberosity fracture (Figure 2). An attempt to reduce sedation dislocations was unsuccessful. The patient was operated on in a semi-seated position, under general anaesthesia, an acromial shoulder approach for both shoulders, a reduction in dislocations was achieved, with a reduction the greater tuberosity and its fixation by two washer screws, both shoulders were immobilized in adduction and internal rotation by elbow slings to the body for 04 weeks followed by functional reeducation.