Ipsilateral elbow and shoulder dislocations in older people: Which joint should be reduced first?: A rare case report and literature review.

Rationale: Ipsilateral simultaneous shoulder and elbow dislocations are rare and complex injuries. Only a few case reports have been published in the literature. Therefore, little is known about the mechanism of injury and its treatment.

Patient concerns: An 83-year-old woman presented with severe pain in the right shoulder and elbow after a fall. Radiographs revealed an unusual ipsilateral dislocation of both the elbow and shoulder, without any fractures.

Diagnoses: Physical examination and radiographs confirmed an unusual ipsilateral dislocation of both the elbow and shoulder, without any fractures.

Interventions: The shoulder dislocation was successfully manipulated without any anesthesia by a doctor first. Following this, the elbow dislocation was successfully treated by the same doctor, with the help of 2 assistants. The patient was then immobilized in a posterior plaster slab for the elbow, and a triangular sling for the shoulder, for a total of 3 weeks.

Outcomes: Seven months after the injury, almost full range of motion was achieved on both joints, with only mild pain, The shoulder score, assessed using the American Shoulder and Elbow Surgeons Scale, was 80, while the elbow score was 87 at the last follow-up.

Lessons: Ipsilateral elbow and shoulder dislocations are very unusual injuries for older people. However, we should not overlook associated injuries on initial assessment, to avoid missing a diagnosis. Excellent functional outcomes may be achievable by an initial closed reduction of the shoulder, followed by treatment of the elbow, particularly in older patients without associated fractures.