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Asymmetric Bilateral Chronic Shoulder Dislocation in a Young Patient – A Rare Case Report

INTRODUCTION: Chronic shoulder dislocations are infrequent and can be easily overlooked unless a carefully clinical history, physical examination, and radiographic evaluation are undertaken. Bilateral simultaneous instability is almost pathognomonic for a convulsive disorder. To the best of our know...

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Autores principales: Diniz, Sara Elisa, Vale, João, Fonte, Hélder, Xará-Leite, Francisco, Barros, Luís Henrique, Claro, Rui
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Indian Orthopaedic Research Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9983375/
https://www.ncbi.nlm.nih.gov/pubmed/36874885
http://dx.doi.org/10.13107/jocr.2022.v12.i10.3382
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author Diniz, Sara Elisa
Vale, João
Fonte, Hélder
Xará-Leite, Francisco
Barros, Luís Henrique
Claro, Rui
author_facet Diniz, Sara Elisa
Vale, João
Fonte, Hélder
Xará-Leite, Francisco
Barros, Luís Henrique
Claro, Rui
author_sort Diniz, Sara Elisa
collection PubMed
description INTRODUCTION: Chronic shoulder dislocations are infrequent and can be easily overlooked unless a carefully clinical history, physical examination, and radiographic evaluation are undertaken. Bilateral simultaneous instability is almost pathognomonic for a convulsive disorder. To the best of our knowledge, we describe the first case of asymmetric bilateral chronic dislocation. CASE REPORT: A 34-year-old male patient with a history of epilepsy and schizophrenia and multiple seizure episodes, suffered a bilateral asymmetric shoulder dislocation. Radiological examination revealed a posterior shoulder dislocation of the right shoulder with a severe reverse Hill-Sachs lesion comprising more than 50% of the humeral head surface, while on the left shoulder, a chronic anterior shoulder dislocation with a Hill-Sachs lesion of moderate dimension. On the right shoulder, a hemiarthroplasty was performed, and on the left, a stabilization with Remplissage Technique, subscapularis plication, and temporary trans-articular Steinmann pin fixation was done. After bilateral rehabilitation, the patient showed residual pain in the left shoulder and slight range of motion limitation. There were no new episodes of shoulder instability. CONCLUSION: Our aim is to emphasize the importance of being alert to flag patients and make a prompt and accurate diagnosis of acute shoulder instability episodes, to avoid unnecessary morbidity, as well as of a high index of suspicion when a history of seizures is present. Despite the uncertain prognosis of a bilateral chronic shoulder dislocation functional results, the surgeon must take into consideration the patient’s age, functional demand, and expectations to define the best treatment strategy.
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spelling pubmed-99833752023-03-04 Asymmetric Bilateral Chronic Shoulder Dislocation in a Young Patient – A Rare Case Report Diniz, Sara Elisa Vale, João Fonte, Hélder Xará-Leite, Francisco Barros, Luís Henrique Claro, Rui J Orthop Case Rep Case Report INTRODUCTION: Chronic shoulder dislocations are infrequent and can be easily overlooked unless a carefully clinical history, physical examination, and radiographic evaluation are undertaken. Bilateral simultaneous instability is almost pathognomonic for a convulsive disorder. To the best of our knowledge, we describe the first case of asymmetric bilateral chronic dislocation. CASE REPORT: A 34-year-old male patient with a history of epilepsy and schizophrenia and multiple seizure episodes, suffered a bilateral asymmetric shoulder dislocation. Radiological examination revealed a posterior shoulder dislocation of the right shoulder with a severe reverse Hill-Sachs lesion comprising more than 50% of the humeral head surface, while on the left shoulder, a chronic anterior shoulder dislocation with a Hill-Sachs lesion of moderate dimension. On the right shoulder, a hemiarthroplasty was performed, and on the left, a stabilization with Remplissage Technique, subscapularis plication, and temporary trans-articular Steinmann pin fixation was done. After bilateral rehabilitation, the patient showed residual pain in the left shoulder and slight range of motion limitation. There were no new episodes of shoulder instability. CONCLUSION: Our aim is to emphasize the importance of being alert to flag patients and make a prompt and accurate diagnosis of acute shoulder instability episodes, to avoid unnecessary morbidity, as well as of a high index of suspicion when a history of seizures is present. Despite the uncertain prognosis of a bilateral chronic shoulder dislocation functional results, the surgeon must take into consideration the patient’s age, functional demand, and expectations to define the best treatment strategy. Indian Orthopaedic Research Group 2022-10 2022-10 /pmc/articles/PMC9983375/ /pubmed/36874885 http://dx.doi.org/10.13107/jocr.2022.v12.i10.3382 Text en Copyright: © Indian Orthopaedic Research Group https://creativecommons.org/licenses/by-nc-sa/3.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Diniz, Sara Elisa
Vale, João
Fonte, Hélder
Xará-Leite, Francisco
Barros, Luís Henrique
Claro, Rui
Asymmetric Bilateral Chronic Shoulder Dislocation in a Young Patient – A Rare Case Report
title Asymmetric Bilateral Chronic Shoulder Dislocation in a Young Patient – A Rare Case Report
title_full Asymmetric Bilateral Chronic Shoulder Dislocation in a Young Patient – A Rare Case Report
title_fullStr Asymmetric Bilateral Chronic Shoulder Dislocation in a Young Patient – A Rare Case Report
title_full_unstemmed Asymmetric Bilateral Chronic Shoulder Dislocation in a Young Patient – A Rare Case Report
title_short Asymmetric Bilateral Chronic Shoulder Dislocation in a Young Patient – A Rare Case Report
title_sort asymmetric bilateral chronic shoulder dislocation in a young patient – a rare case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9983375/
https://www.ncbi.nlm.nih.gov/pubmed/36874885
http://dx.doi.org/10.13107/jocr.2022.v12.i10.3382
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