Retching as an unusual cause of bilateral posterior shoulder fracture dislocation

Abstract

Bilateral posterior shoulder fracture dislocation is a debilitating injury and is quite rare. This injury pattern has been described in the literature as either secondary to seizure, electrocution or major trauma. We present a case of an elderly man who appears to have sustained the injury after an episode of retching and vomiting. With our patient witnessed closely throughout and no trauma, electrocution or seizure activity reported, we propose that the violent action of retching and vomiting not only has the potential to cause this injury pattern but also was the only credible cause in our patient. This case not only adds to the list of potential injuries caused by retching and vomiting but also questions the validity of a previously limited list of modes-of-injury for posterior shoulder fracture dislocation.

Keywords: orthopaedic and trauma surgery; orthopaedics; shoulder instability; trauma.