Chronic bilateral symmetric anterior shoulder dislocation – A rare case report

Abstract

Introduction: Chronic bilateral shoulder dislocation is a rare occurrence. The most common type is the posterior type, as described by Cooper in 1839. Case report: We report the case of a sixty years old female with spinocerebellar ataxia who presented with progressive limitation of arm mobility. Additionally, she also suffered a fall 3 days ago, which exacerbated pain. Radiographs documented a bilateral subcoracoid anteromedial gleno-humeral dislocation, classified as chronic. An attempt of close reduction under sedation was performed bilaterally. While reduction was achieved on the left side, the shoulder immediately dislocated. The right side, on the other hand, was irreducible. Due to persistent instability and pain in the left shoulder, an open reduction was performed, and an additional Latarjet procedure was undertaken to achieve stability. At present, with a 2-year follow-up (FUP), the left shoulder remains reduced and stable, the patient is pain-free, and she is functionally autonomous in most day-to-day activities, including self-hairdressing. Discussion: This case presents a rare and complex condition. To the best of our knowledge, this is the 13th reported case. Conclusion: Therefore, in the absence of consensual guidelines for management and treatment, the decision-making process is still based on the surgeon's experience and preference, taking into consideration patient's individual circumstances. In our case, we opted for the less invasive surgical treatment, which yielded a very satisfactory result from the patient's perspective.