Bilateral Anterior Omuz Çıkığı

Abstract

Bilateral anterior omuz çıkığı, nadir görülen ve genellikle yüksek enerjili travmalarla ilişkilendirilen bir durumdur. Bu olguda, düşük enerjili travma sonrası gelişen bilateral anterior omuz çıkığı nedeniyle başvuran 73 yaşında kadın hasta sunulmuştur. Hasta, koşu bandında yürürken öne doğru düşme sonrası her iki omuzda ağrı ve hareket kısıtlılığı yaşamıştır. Fizik muayenede bilateral apolet bulgusu ve omuzlarda abduksiyon-dış rotasyon pozisyonu mevcuttu. Radyografik incelemede, kırık eşlik etmeyen bilateral subkorakoid anterior omuz çıkığı saptanmıştır. Sedoanaljezi altında Kocher manevrası ile redüksiyon sağlanmış, redüksiyon sonrası her iki omuzun hareket açıklığında artış gözlenmiştir. Redüksiyonun ardından kol-gövde bandajı uygulanmış ve ortopedi polikliniğine yönlendirilerek taburcu edilmiştir. Bu olgu, yaşlı bireylerde düşük enerjili travmaların dahi ciddi eklem yaralanmalarına yol açabileceğini göstermesi açısından dikkat çekicidir. Travma sonrası omuz ağrısı ile başvuran hastalarda, bilateral omuz çıkığı tanısı akılda tutulmalı; hızlı değerlendirme ve uygun müdahale ile komplikasyonlar önlenmelidir.

Keywords

• Bilateral yaralanma
• Düşmeye bağlı travma
• Omuz çıkığı

Bilateral Anterior Shoulder Dislocation

Abstract

Bilateral anterior shoulder dislocation is a rare condition typically associated with high-energy trauma. In this report, we present a 73-year-old female patient who developed bilateral anterior shoulder dislocation following a low-energy fall. The patient experienced sudden bilateral shoulder pain and limited range of motion after falling forward while walking on a treadmill. Physical examination revealed bilateral “epaulet sign” and shoulders held in abduction and external rotation. Radiographs demonstrated bilateral subcoracoid anterior shoulder dislocation without accompanying fractures. Closed reduction was successfully performed under sedoanalgesia using the Kocher maneuver on both shoulders sequentially. Post-reduction imaging confirmed anatomical alignment, and a noticeable improvement in the range of motion was observed. Bilateral arm-to-body slings were applied and the patient was discharged with outpatient orthopedic follow-up. This case highlights that even low-energy trauma in elderly individuals may lead to significant musculoskeletal injuries. Bilateral shoulder dislocation, though uncommon, should be considered in elderly patients presenting with post-traumatic shoulder pain. Prompt diagnosis and appropriate management are essential to prevent complications and ensure optimal outcomes.

Keywords

• Accidental falls
• Bilateral injuries
• Shoulder dislocation

References

1. Antri, I. E., Benyass, Y., & Zine, A. (2020). Simultaneous bilateral anterior shoulder dislocation as a result of minimal trauma. The Pan African medical journal, 36, 94. https://doi.org/10.11604/pamj.2020.36.94.23757
2. Ballesteros, R., Benavente, P., Bonsfills, N., Chacón, M., & García-Lázaro, F. J. (2013). Bilateral anterior dislocation of the shoulder: review of seventy cases and proposal of a new etiological-mechanical classification. The Journal of emergency medicine, 44(1), 269-279.
3. Chahal, J., Leiter, J., McKee, M. D., & Whelan, D. B. (2010). Generalized ligamentous laxity as a predisposing factor for primary traumatic anterior shoulder dislocation. Journal of shoulder and elbow surgery, 19(8), 1238–1242. https://doi.org/10.1016/j.jse.2010.02.005
4. Meena, S., Saini, P., Singh, V., Kumar, R., & Trikha, V. (2013). Bilateral anterior shoulder dislocation. Journal of natural science, biology, and medicine, 4(2), 499–501. https://doi.org/10.4103/0976-9668.117003
5. Mynter H. (1902). XIV. Subacromial Dislocation from Muscular Spasm. Annals of Surgery, 36(1), 117–119. https://doi.org/10.1097/00000658-190207000-00014
6. Ozan, F., Altay, T., Koyuncu, Ş., & Çeliker, H. (2014). Bilateral anterior shoulder dislocation: A case report and a review of the literature. Ege Journal of Medicine, 53(1), 56-59.
7. Parrish, G. A., & Skiendzielewski, J. J. (1985). Bilateral posterior fracture-dislocations of the shoulder after convulsive status epilepticus. Annals of emergency medicine, 14(3), 264–266. https://doi.org/10.1016/s0196-0644(85)80453-4
8. Schneider, K. N., Schliemann, B., Manz, S. M., Buddhdev, P. K., & Ahlbäumeri, G. (2017). Bilateral Anterior Shoulder Dislocation in the Elderly - A Case Report and Review of the Literature. Journal of orthopaedic case reports, 7(5), 42–49. https://doi.org/10.13107/jocr.2250-0685.890

9. Sharma L, Pankaj A, Kumar V, Malhotra R, Bhan S. Bilateral anterior dislocation of the shoulders with proximal humeral fractures: a case report. J Orthop Surg 2005; 13:303-6.
10. Shin, S. J., Yun, Y. H., Kim, D. J., & Yoo, J. D. (2012). Treatment of traumatic anterior shoulder dislocation in patients older than 60 years. The American journal of sports medicine, 40(4), 822–827. https://doi.org/10.1177/0363546511434522
11. Thakur A., Gupta R., Kotwal, V., & Arora D. (2010). A rare case of bilateral anterior dislocation of the shoulder. Journal of Clinical and Diagnostic Research, 4(6), 3567-3569.
12. Turhan, E., & Demirel, M. (2008). Bilateral anterior glenohumeral dislocation in a horse rider: a case report and a review of the literature. Archives of orthopaedic and trauma surgery, 128(1), 79–82. https://doi.org/10.1007/s00402-007-0347-2