Both arms continued selleck compound to be neurvascularily intact and were armpouch in slings. Right shoulder was immobilized for one week and left shoulder for six weeks. Figure 1 Radiographs demonstrating the bilateral anterior shoulders dislocation with fracture greater tuberosity left side Figure 2 (a and b) Post-reduction X-ray showing congruent reduction of bilateral shoulder joint and anatomically reduced greater tuberosity fracture left side The patient received physical therapy as tolerated and no further episodes of instability ensued. At follow-up of two months the patient reported no pain and had returned to his normal activities of daily living with minimal discomfort. Both shoulders had near normal range of motion with pain only present at the extremes of motion. Both shoulders also had negative apprehension tests.

Power was 5/5 in both shoulders. Radiographs showed an anatomical consolidation of greater tuberosity fracture of left shoulder joint. At the end of one year follow up, the fracture has united with no restriction of motion and the shoulders were defined as stable. DISCUSSION As opposed to unilateral shoulder dislocations, simultaneous bilateral shoulder dislocations are rare occurrences. Bilateral shoulder dislocation was first described in 1902 in patient in whom excessive muscular contractions occurred as a result of Camphor overdose.[1] Evidence from the literature suggests that they are mostly posterior. Bilateral anterior dislocation however is still rarer. Dinopoulos et al., in 1999 found only 28 reported cases since 1966.[2] Dunlop et al.

, reported in 2002 of other cases in the literature, but most were associated with fractures. He also found that of the 44 cases, five were diagnosed late.[3] Bilateral posterior shoulder dislocations occur mostly due to electrical shock, seizures or hypoglycaemic episodes, and these occur as a sequel of maximal involuntary muscle contractions. The weaker external rotating muscles are overpowered by the stronger internal rotators, resulting in adduction and internal rotation sufficient dislocate the humeral head posteriorly. Unlike posterior dislocations, anterior dislocations occur more commonly following trauma. Our patient had minor trauma after falling backwards with his arms extended behind his back. The dislocation mechanism in our case is a protective effort in an unbalanced position both created a typical shoulder dislocation mechanism.

This is the first case reported of a patient dislocating both shoulder by this mechanism. Cresswell and Smith reported a case of bilateral anterior dislocation of the shoulder without any fractures in a bench-pressing athlete.[4] Singh and Kumar reported a case of sequential bilateral anterior dislocation in which the left shoulder dislocated first due to trauma AV-951 followed by atraumatic dislocation of the right shoulder.[5] Galois et al.