Atraumatic Bilateral Anterior Shoulder Dislocation With Bilateral Greater Tuberosity Fractures Accompanied by the Diagnosis of Epilepsy: A Case Report.

Abstract

Case: A 23-year-old female patient with no previously known medical conditions presented to the orthopedic clinic with bilateral shoulder pain persisting since the previous day after an episode of loss of consciousness and convulsions. She had no history of trauma during the event and had been evaluated in the emergency department with a preliminary diagnosis of an epileptic seizure before discharge following acute medical treatment. Bilateral anterior shoulder dislocation with accompanying bilateral greater tuberosity fractures was identified. Both shoulders were reduced under sedation, followed by surgical fixation due to >10 mm fragment displacement and instability risk. A cannulated screw and washer were used on the right side, and plate osteosynthesis on the left, resulting in favorable functional outcomes after rehabilitation.

Conclusion: Bilateral greater tuberosity fractures associated with atraumatic bilateral anterior shoulder dislocation due to an epileptic seizure are exceedingly rare and may represent the first manifestation of epilepsy. This case demonstrates that seizure-induced muscle contractions can cause severe extremity injuries without external trauma; therefore, every post-seizure patient requires systematic extremity examination and early orthopaedic review. Appropriate surgical management with a multidisciplinary approach can yield favorable functional outcomes.