Bilateral posterior four-part fracture-dislocation of the shoulder

A case of a bilateral posterior four-part fracture dislocation of the shoulder after a convulsive seizure was treated conservatively on one side, while the other shoulder was replaced by a hemiarthroplasty. A review of the literature and a treatment protocol for managing these injuries are presented. In four-part fracture-dislocations good results can be achieved with conservative treatment, but when avascular necrosis is likely to occur (delay in diagnosis or dubious relationship of the fragments after reduction) it is better to replace the humeral head.