1
Department of Orthopaedic Surgery, Washington University in St. Louis, MO, USA
2
Washington University School of Medicine, St. Louis, MO, USA
10.22038/abjs.2024.67743.3211
Abstract
Objectives: To compile the existing literature on bilateral anterior shoulder dislocation (BASD) and analyze patient demographics, mechanisms of injury, injury characteristics, management, and outcome . Methods: This systematic review was conducted in accordance with Preferred Reporting Items for Systematic review and Meta-Analyses (PRISMA) guidelines. Online databases, including Ovid Medline 1946-, Embase.com 1947-, Scopus 1960-, Cochrane Central, and Clinicaltrials.gov were systematically queried. Studies eligible for inclusion were case reports or case-series, documenting BASD. Two reviewers independently screened and applied a set of a priori exclusion criteria to each returned study. Data were extracted, compiled, and synthesized from each reported case of BASD. Contingency tables/Chi-Square Analyses, T-tests, and univariate regression analyses were conducted to assess relationships between different variables. Results: Eighty-one studies (87 cases of BASD) were included. Patients were 41.1 (SD± 19.5) years old and most were male (n=63; 72.4%). Around a quarter of patients (28.7%) had a history of epilepsy/seizures or were being worked-up for such. Younger males were more likely to have BASD due to a seizure or electrocution (P<0.05). Close to a third of cases (n=27; 31.0%) were delayed in presentation. Those sustaining seizures or electrocutions were more likely to be delayed in presentation (P=0.013). Most events resulted in simple dislocations that were closed reduced successfully. BASD resulting from seizures or electrocutions were more likely to be fracturedislocations (P=0.018); and in younger patients with fracture-dislocations, closed reduction was more often to fail or not be attempted (P<0.05). Median follow-up was 6 months (IQR: 3 months – 12 months). Seven patients (10.6%) had complications and 4 (2.3%) demonstrated recurrent instability. Conclusion: In young males presenting with BASD without known trauma, suspicion should be high for a convulsant event. In patients with a known seizure disorder who present with chronic bilateral shoulder or arm pain, BASD should be considered and work-up should be expedited to avoid misdiagnosis. Level of evidence: V
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Kuhn, A., Landes, E., Yu, J., Inclan, P., Hill, J., & Aleem, A. (2024). Bilateral Anterior Shoulder Dislocation: A Systematic Review. The Archives of Bone and Joint Surgery, 12(5), 306-327. doi: 10.22038/abjs.2024.67743.3211
MLA
Andrew W. Kuhn; Emma K. Landes; Justin K. Yu; Paul M. Inclan; J. Ryan Hill; Alexander W. Aleem. "Bilateral Anterior Shoulder Dislocation: A Systematic Review". The Archives of Bone and Joint Surgery, 12, 5, 2024, 306-327. doi: 10.22038/abjs.2024.67743.3211
HARVARD
Kuhn, A., Landes, E., Yu, J., Inclan, P., Hill, J., Aleem, A. (2024). 'Bilateral Anterior Shoulder Dislocation: A Systematic Review', The Archives of Bone and Joint Surgery, 12(5), pp. 306-327. doi: 10.22038/abjs.2024.67743.3211
VANCOUVER
Kuhn, A., Landes, E., Yu, J., Inclan, P., Hill, J., Aleem, A. Bilateral Anterior Shoulder Dislocation: A Systematic Review. The Archives of Bone and Joint Surgery, 2024; 12(5): 306-327. doi: 10.22038/abjs.2024.67743.3211
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