Bilateral Posterior Fracture-Dislocation of Shoulder Following Seizures Secondary to Cavernous Sinus Venous Thrombosis - A Rare Association.

Introduction: Bilateral posterior fracture dislocation of both shoulders is a rare condition which can easily be missed due to its imprecise presentation. In this case report, we emphasize its diagnosis and summarize the various treatment options available for bilateral posterior fracture-dislocation of shoulders and also its management in conjunction with cavernous sinus venous thrombosis (CSVT).

Case Report: A 29-year-old gentleman had bilateral posterior fracture-dislocation of shoulders, with comminuted three-part fractures of both humeral heads, after two episodes of seizures, following CSVT. Unlike posterior fracture-dislocation secondary to any other causes, patients with CSVT are usually intensive care unit bound and have low Glasgow coma scale, in a state of inability to complain, causing a delay in diagnosis and chances of delay in treatment due to the concomitant treatment of CSVT. This patient was treated in coordination with the neurologists and operated by bilateral open reduction and internal fixation using proximal humerus locking plates and greater tuberosity reconstruction. 2 years post-operatively, the patient had painless shoulders, with satisfactory and functional range of motion.

Conclusion: Bilateral shoulder screening using computed tomography scan is helpful for diagnosing bilateral shoulder posterior fracture-dislocation, which can be easily missed in patients presenting with Triple E pathologies. Early recognition and appropriate treatment are very much essential in giving best functional outcomes of such cases.