PT  - JOURNAL ARTICLE
AU  - Tellisi, Nazzar K.
AU  - Abusitta, Gehad R.
AU  - Fernandes, Richard J.
TI  - Bilateral posterior fracture dislocation of the shoulders following seizure
DP  - 2004 Nov 01
TA  - Saudi Medical Journal
PG  - 1727--1729
VI  - 25
IP  - 11
4099  - http://smj.org.sa/content/25/11/1727.short
4100  - http://smj.org.sa/content/25/11/1727.full
SO  - Saudi Med J2004 Nov 01; 25
AB  - Bilateral posterior fracture dislocation is a rare injury known to be associated with seizures. Convulsion was found to be the cause of fracture dislocation in 78% of the cases reported. The mechanism of injury was described by Shaw in 1971. The management depends largely on the severity of the injury. In many cases reported, the fracture was a large compression defect in the anteromedial aspect of the articular surface of the humeral head. It has been suggested that for defects that involve less than 20% of the articular surface closed reduction can be attempted. Rush nail or percutaneous K wires can be used to maintain reduction. Open reduction is necessary for defects that are involving 20-40% of the surface. The aim in these cases is to reconstruct the proximal humerus if possible by the use of internal fixation. If reconstruction is not feasible, a modified McLaughlin procedure can be used to prevent chronic instability of the shoulder. This procedure involves re-implanting the subscapularis tendon into the defect. Reconstructing fractures that involve more than 40% of the articular surface or 4-part fracture is not usually successful. These fractures are associated with a high the risk of avascular necrosis. Hemi-arthroplasty or total shoulder replacement is generally regarded as better option as they offer rapid recovery and eliminate the possibility of multiple procedures if fixation fails.