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Asymmetric Bilateral Chronic Shoulder Dislocation in a Young Patient - A Rare Case Report
Sara Elisa Diniz1,2, João Vale1,2, Hélder Fonte1,2
1Department of Orthopaedics, Centro Hospitalar Universitário do Porto-Hospital de Santo António, Porto, Portugal.
Journal of Orthopaedic Case Reports
|March 6, 2023
Summary
This case report details the first instance of asymmetric bilateral chronic shoulder dislocation in a patient with epilepsy and schizophrenia. Prompt diagnosis and tailored surgical strategies are crucial for managing this rare condition.
Area of Science:
- Orthopedics
- Traumatology
- Neurology
Background:
- Chronic shoulder dislocations are rare and often missed without thorough evaluation.
- Bilateral shoulder instability strongly suggests a convulsive disorder.
- Prompt diagnosis of shoulder instability is vital to prevent morbidity.
Observation:
- A 34-year-old male with epilepsy and schizophrenia presented with bilateral asymmetric chronic shoulder dislocation.
- Radiological findings included a posterior dislocation with a large reverse Hill-Sachs lesion on the right and an anterior dislocation with a moderate Hill-Sachs lesion on the left.
- Treatment involved hemiarthroplasty on the right and Remplissage Technique with subscapularis plication on the left.
Findings:
- The patient experienced residual pain and limited range of motion in the left shoulder post-rehabilitation.
- No further episodes of shoulder instability occurred after treatment.
- This case represents the first documented instance of asymmetric bilateral chronic shoulder dislocation.
Implications:
- Highlights the importance of considering shoulder instability in patients with seizure disorders.
- Emphasizes the need for a high index of suspicion for prompt and accurate diagnosis.
- Surgical treatment strategies for bilateral chronic shoulder dislocation must be individualized based on patient factors.
