Ulus Travma Acil Cerrahi Derg. 2024; 30(10): 761-763 | DOI: 10.14744/tjtes.2024.84935

Bilateral anterior shoulder dislocation: A case report

Bedrettin Akar
Ministry of Health Sakarya Yenikent State Hospital, Sakarya-Türkiye

Bilateral anterior shoulder dislocation (BASD) is a rare condition typically associated with a history of trauma. This case report presents a patient with BASD resulting from trauma and discusses treatment options. A 51-year-old male patient was admitted to the emergency department following a fall from a height. Radiographic examination revealed BASD and a comminuted intra-articular fracture of the distal end of the left radius. The patient did not have any other additional pathologies. After a preoperative evaluation, the patient was urgently taken to the operating room, where both shoulders underwent reduction using the Hippocratic maneuver under sedation anesthesia. Immediately after this procedure, the left wrist was reduced closed, and a penning-type external fixator was inserted under fluoroscopic guidance. Following the reductions, both shoulders were wrapped with a Velpeau bandage and immobilized. An elastic bandage was wrapped around the wrist. By the end of the third week, shoulder mobility exercises were initiated, with a gradual increase in the intensity of the exercises. The wrist fixator was removed in the fifth week after radiographic evaluations, followed by the initiation of passive and then active exercises. Given the rarity of BASD, it is crucial to obtain a detailed clinical history, conduct a comprehensive clinical examination, and perform detailed imaging studies-radiography, computed tomography, and magnetic resonance imaging to avoid overlooking such pathologies in emergency situations. Bilateral anterior shoulder dislocation is a pathology that results from major trauma. It is important to remember that this particular type of pathology may be accompanied by various other pathologies, such as fractures (of the tuberculum majus), rotator cuff injuries, and neurovascular injuries.

Keywords: Complication, emergency therapy; shoulder dislocation; trauma; orthopedic surgery.

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Bilateral anterior omuz çýkýðý: Olgu sunumu

Bedrettin Akar
Saðlýk Bakanlýðý Sakarya Yenikent Devlet Hastanesi, Sakarya, Türkiye

Bilateral anterior omuz çýkýklarý (BAOÇ); nadir vakalar olup genellikle etiyolojisinde travma hikayesi bulunmaktadýr. Çalýþmamýzýn amacý; travma sonucu geliþen BAOÇ vakasýný ve tedavi seçeneklerini olgu sunumu eþliðinde deðerlendirmektir.51 yaþ erkek hasta, yüksekten düþme hikayesi ile acil servise baþvurdu. Hastanýn çekilen grafilerinde, BAOÇ ve sol radius distal ucunda eklem içi parçalý fraktür görüldü. Hastanýn baþka ek bir patolojisi yoktu. Preop tetkiklerinin yapýlmasýnýn ardýndan hasta acil olarak ameliyathaneye alýndý. Hastanýn sedatif anestezi altýnda her iki omuzu Hipokrat manevrasý ile redükte edildi. Hemen ardýndan sol el bileði kapalý olarak redükte edilerek skopi eþliðinde penning tipi eksternal fiksatör uygulandý. Redüksiyon sonrasý iki omuz velpau bandajý ile sarýlarak immobilize edildi. El bileðine elastik bandaj sarýldý. 3. hafta sonunda omuz hareketlerine baþlanarak egzersizler progressif olarak arttýrýldý. El bilek fiksatörü ise radyografi ile yapýlan kontroller sonrasý 5. haftada çýkarýlarak önce pasif sonra aktif egzersizlere baþlandý. Anterior omuz çýkýklarý çok nadir görüldüðünden, acil þartlarda bu tip patolojilerin atlanmamasý için detaylý klinik öykü, kapsamlý bir klinik muayene ve ayrýntýlý görüntüleme (Radyografi, CT, MR) çok önemlidir. Bilateral Anterior omuz çýkýklarý major travma sonucu meydana gelen patolojilerdir. Bu tip patolojilere; kýrýklar (Tuberkulum majus), rotatuar manþet yaralanmalarý ve nörovaskuler yaralanmalar gibi farklý patolojilerinde eþlik edebileceði unutulmamalýdýr.

Anahtar Kelimeler: Acil tedavi, komplikasyon; omuz çýkýðý; ortopedik cerrahi; travma.

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