Bilateral irreducible inferior shoulder dislocation: A case report.

Area of Science:

• Orthopedic Surgery
• Traumatology
• Anatomy

Background:

• Bilateral inferior shoulder dislocation is exceptionally rare.
• Most inferior shoulder dislocations are amenable to closed reduction.
• This report describes a unique instance of irreducible bilateral inferior shoulder dislocation.

Purpose of the Study:

• To present a rare case of irreducible bilateral inferior shoulder dislocation.
• To elucidate the pathomechanics of irreducibility in this specific injury.
• To outline essential surgical techniques for successful open reduction.

Main Methods:

• A 35-year-old male sustained bilateral inferior shoulder dislocation after a fall.
• Closed reduction attempts were unsuccessful.
• Open reduction was performed, revealing button-hole entrapment of the humeral heads within the inferior joint capsule and surrounding soft tissues.

Main Results:

• The irreducibility was attributed to the button-hole entrapment of the humeral head through a defect in the inferior joint capsule and soft tissues.
• Open reduction involved carefully widening this defect to release the entrapped humeral heads.
• Protection of the axillary neurovascular bundle was critical during the procedure.

Conclusions:

• Button-hole entrapment of the humeral head is a key factor in the irreducibility of this type of shoulder dislocation.
• Open reduction requires meticulous technique, including widening the entrapment site and safeguarding neurovascular structures.
• While functional recovery was good at 6 months, some residual limitation in shoulder abduction may occur.