Reversed total shoulder arthroplasty for a bilateral posterior shoulder fracture-dislocation and ORIF of a periprosthetic humeral fracture: A case report

Abstract

Background: Posterior dislocations of the shoulder are rare, however more common in seizures. The uncoordinated flexing of muscles which facilitate internal rotation and adduction can cause simple unilateral subluxation or even severe bilateral fracture-dislocations of the shoulder joint. This report aims to present the surgical management of a case in which a bilateral posterior shoulder fracture-dislocation occurred due to a seizure. After treatment via one stage bilateral reversed total shoulder arthroplasty, a periprosthetic humeral fracture ensued, which was treated with open reduction and internal fixation. Case report: The patient, male, 71 years, was admitted to the emergency department after a seizure, which caused a bilateral posterior shoulder fracture-dislocation. This was surgically managed via a one stage bilateral reversed total shoulder arthroplasty. After 8 months, a periprosthetic humeral fracture ensued which was managed via open reduction and internal fixation. Conclusion: In the management of posterior shoulder fracture-dislocations in aged patients with and without an irreparable supraspinatus tear, reversed total shoulder arthroplasty can provide a fair result with good function and pain relief, even when being performed in one stage bilaterally. Furthermore, open reduction and internal fixation of an ensuing periprosthetic humeral fracture can be safe and effective, especially in well-fixed stems.

Keywords

• Posterior shoulder fracture-dislocation
• Reversed total shoulder arthroplasty
• Periprosthetic humeral fracture
• Open reduction internal fixation
• Case report