Posterior Shoulder Fracture Dislocations Associated With Seizure Disorders

Abstract

Background: Posterior fracture dislocation of the shoulder is an extremely rare injury and is associated with poor outcomes if not managed properly and in a timely manner. When associated with seizure disorders the injuries are likely to be more serious a compared to simple posttraumatic cases. Only about 4% of glenohumeral dislocations are posterior and 1% have an associated fracture of the humeral head.

Methods: This case report is about posterior shoulder fracture dislocations associated with first seizure disorders in previously normal young adult patients aged 21 and 38 years who were not on treatment for seizure disorders. Both patients were treated by open reduction and internal fixation using proximal humerus locking plates after failed attempted closed reduction.

Results: Both patients had a good outcome with fracture healing and good range of motion at one year of follow up.

Conclusion: Computed Tomography Scanning (CT Scan) is useful in pre operative assessment of the injury pattern since upto 50% of the posterior dislocations are missed on plain AP X-ray of the shoulder. Open reduction via the deltopectoral approach offers the best chance of anatomic reduction with better outcomes in young patients with a posterior fracture dislocation especially the locked ones.