19 June 2023
: Case report 
Bilateral Locked Posterior Fracture-Dislocation of the Shoulder After Epileptic Seizures Secondary to Cavernous Hemangioma: A Case Report and Literature Review
Challenging differential diagnosis, Diagnostic / therapeutic accidents, Management of emergency care, Rare disease
Andreas Pangopoulos
1ABCDE*, Spyridon Papagiannis 1BEF, Konstantinos Koutas1ABCDEF, Zinon T. Kokkalis 1CD
DOI: 10.12659/AJCR.940141
Am J Case Rep 2023; 24:e940141
Table 1. Cases of bilateral posterior locked fracture-dislocations found in the literature.
| Authors | Mechanism of injury | Type of lesion | Treatment | Follow-up (months) | Outcome | |
|---|---|---|---|---|---|---|
| Brackstone et al []9 | Nontraumatic, manual activity, with no witnessed seizure | N/A | One-stage hemiarthroplasty on both sides | 12 | Satisfactory functional outcome | |
| Pushpakumara et al []10 | Epileptic seizure episode | Surgical neck fracture on both sides | Closed reduction, conservative treatment | 6 | Satisfactory range of motion | |
| Din et al[]12 | Epileptic seizure episode | 4-part fractures on both sides | Open reduction and internal fixation | 18 | Satisfactory clinical outcome | |
| Cautero et al []19 | Epileptic seizure episode | Osteochondral defect of the right femoral head-around 40%, N/A information for the left side | Arthroplasty on both sides in 2 stages | N/A | Complete strength and passive and active range of motion on both shoulders | |
| Kasha et al[]21 | Seizures Secondary to Cavernous Sinus Venous Thrombosis | Bilateral, three-part fracture-dislocations. | One-stage open reduction and internal fixation on both sides | 24 | Painless shoulders-satisfactory and functional range of motion | |
| Torrens et al []22 | Epileptic seizure episode | Impression fracture of both humeral heads-50% on both sides | Osteochondral autografts on the right side. Hemiarthroplasty on the left side in one stage | 24 | Free range of motion-no pain | |
| Elmali et al[]23 | Epileptic seizure episode. | Impression fracture of both humeral heads-40% on the right side, 30% on the left | Osteochondral allografts on the right side-modified McLaughlin on the left side in one stage | 14 | Pain-free with stable shoulder joints and satisfactory functionality | |
| Ryan et al[]24 | Fall from standing height-no history of seizures | N/A | N/A | N/A | N/A | |
| Kokkalis et al []25 | Epileptic seizure episode | Reverse Hill-Sachs lesions-articular defects of 35% and 40%. | Modified McLaughlin technique on both shoulders in one stage | 22 | Satisfactory level of function; both shoulder joints were painless and stable without apprehension | |
| Engel et al[]26 | Epileptic seizure episode | Reverse Hill-Sachs lesions-articular defects of 20% on the left side and 40% on the right side | Open reduction and internal fixation | 6 | No pain-free range of motion. | |
| Ivkovic et al []27 | Epileptic seizure episode | Articular deficit of more than 50% on the right side and 40% on the left side | Hemiarthroplasty on the right side and reconstruction of the head by an osteochondral autograft on the left side | 36 | Excellent clinical and radiological results | |
| Wu et al []28 | 1. Unexpected fall-no history of epilepsy2. Electrocution | 3-part fracture on the left side and a 2-part fracture on the right sidePosterior 4-part fracture-dislocation on the left side- posterior 2-part fracture-dislocation of the right side | Both cases treated with open reduction and internal fixation-plate fixation on the left side and cancellous screw fixation on the right side | 1624 | Satisfying level of function.Painless and stable with acceptable range of motion. | |
| Ben Fadhel et al []29 | First epileptic seizure episode | Reverse Hill-Sachs lesions-articular defects of 30% and 40% | Modified McLaughlin technique on both shoulders in one stage | 14 | Patient returned to previous level of activity | |
| Murphy et al []30 | First epileptic seizure episode | 4-part fractures on both sides | Reverse total shoulder arthroplasty on both sides | 4 | Uneventful recovery | |
| Zanini et al[]31 | Fall from height | Reverse Hill-Sachs lesions-articular defects of 25% on the left side and 40% on the right side | Reverse shoulder arthroplasty on the right side and osteochondral autograft on the left side | 18 | Painless free range of motion | |
| Kechagias et al []32 | Electric shock | Defects over 50% of the head articular surfaces on both sides | One-stage hemiarthroplasty on both sides | 12 | Painless free range of motion | |
| Gurzi et al[]33 | Epileptic seizure episode | 3-part fracture on the right side-severe comminution with involvement of 50% of the femoral head on the left side | Open reduction and internal fixation on the right side-hemiarthroplasty on the left side | 24 | Return to previous working activitie | |
| Page et al[]34 | Epileptic seizure episode. | Defects over 50% of the head articular surfaces on both sides | One-stage hemiarthroplasty on both sides | 12 | Unrestricted range of motion-returned to work | |
| Uppal et al []35 | 4 cases: all caused by seizures. | Bilateral reverse Hill-Sachs-not quantified.The less affected head was used for autografts | 2 cases treated with osteochondral grafts and arthroplasty (hemi and reverse)1 case with bilateral hemiarthroplasty1 case with combined open reduction and internal fixation and hemiarthroplasty | 34 | Satisfactory functional outcomes | |
| Jansen et al []36 | First epileptic seizure episode | Posterior fracture-dislocation-no other information available | Open reduction and internal fixation on the left side-hemiarthroplasty on the right side | 36 | AVN on the left side at 12 months-conversion to reverse total shoulder arthroplastyPainless range of motion up to 90° of abduction and elevation | |
| Pathinathan et al []37 | Epileptic seizure episode | Two-part fracture on the right side and comminuted greater and lesser tuberosity fractures on the left side | Closed reduction-conservative treatment (patient’s choice) | 12 | Radiological evidence of healing and he regained his normal shoulder functions | |
| Konda et al []38 | Drug induced seizure | Bilateral reverse Hill-Sachs-not quantified | Modified McLaughlin technique on both shoulders in one stage | 3 | Good clinical outcomes | |
| Mnif et al[]39 | Undefined-no trauma | Bilateral comminuted fracture-dislocations | One-stage hemiarthroplasty on both sides | 36 | Fair clinical outcomes. | |
| O’Neill et al []40 | Seizure caused by vit D deficiency | Large impaction on the left side-fracture-dislocation on the right side | Right shoulder hemiarthroplasty and internal fixation on the left side | N/A | N/A | |
| Ifensaya et al []41 | Epileptic seizure episode | Undefined | Conservative treatment | 9 | Return to work | |
| Begin et al[]42 | Epileptic seizure episode | Articular defects of 30% on the left side and 60% on the right side | One-stage autograft reconstruction of both humeral heads | 36 | Good clinical outcomes | |
| El Rassi et al []43 | Status epilepticus | Four-part fracture-dislocation on both sides | One-stage bilateral reverse shoulder arthroplasty | 6 | Satisfactory clinical outcomes | |
| Azad et al[]44 | Hypoglycemia induced seizure | Four-part fracture-dislocation on both sides | One-stage bilateral reverse shoulder arthroplasty | 12 | Painless free range of motion | |
| Saylik et al[]45 | Epileptic seizure episode | Articular defects of 32% on the left side and 36% on the right side | Modified McLaughlin technique on both shoulders in one stage | 12 | Good clinical outcomes | |
| Wendling et al []46 | Epileptic seizure episode | Four-part fracture-dislocation on both sides | One-stage bilateral reverse shoulder arthroplasty | 10 | Good clinical outcomes | |
| Lindholm et al []47 | Epileptic seizure episode | Four-part fracture-dislocation on both sides | Open reduction and internal fixation | 12 | Satisfactory clinical outcome | |
| Kilicoglu et al []48 | Brain tumor | Articular defects of 50% on the left side and 45% on the right side | One-stage bilateral shoulder hemiarthroplasty | 12 | The patient was able to perform routine daily activities without any problems |