# Bilateral anterior shoulder dislocations: A review of two cases and the relevant literature

Malick Diallo, Massadiami Soulama, Delwendé Serge Romaric Kaboré, Patrick Dakouré, Philippe Liverneaux

<figure><img src="image_1.png" /></figure>

## ► To cite this version:

Malick Diallo, Massadiami Soulama, Delwendé Serge Romaric Kaboré, Patrick Dakouré, Philippe Liverneaux. Bilateral anterior shoulder dislocations: A review of two cases and the relevant literature. Clinical Case Reports, 2020, 8 (12), pp.3378-3387. 10.1002/ccr3.3351. hal-05484881

HAL Id: hal-05484881

https://univoak.hal.science/hal-05484881v1

Submitted on 30 Jan 2026

HAL is a multi-disciplinary open access
archive for the deposit and dissemination of sci-
entific research documents, whether they are pub-
lished or not. The documents may come from
teaching and research institutions in France or
abroad, or from public or private research centers.

L'archive ouverte pluridisciplinaire HAL, est
destinée au dépôt et à la diffusion de documents
scientifiques de niveau recherche, publiés ou non,
émanant des établissements d'enseignement et de
recherche français ou étrangers, des laboratoires
publics ou privés.

<figure><img src="image_2.png" /></figure>

Distributed under a Creative Commons CC BY 4.0 - Attribution - International License
# Bilateral anterior shoulder dislocations: A review of two cases and the relevant literature

Malick Diallo<fnref n="1" /> ID | Massadiami Soulama<fnref n="1" /> | Delwendé Serge Romaric Kaboré<fnref n="1" /> |
Patrick W. H. Dakouré<fnref n="1" /> | Philippe Liverneaux<fnref n="2" /> ID

**Correspondence**

Malick Diallo, Service d'Orthopédie-
Traumatologie, CHU Sourô Sanou
(CHUSS), Nazi BONI University, 01 BP
1091 Bobo-Dioulasso 01, Burkina Faso.

Email: malikijallo@yahoo.com

**Abstract**

The bilateral symmetric anterior shoulder dislocations (BSASD) must be suspected in patients with bilaterally flattened shoulders after an uncontrolled muscular contraction like seizure condition. BSASD is best managed acutely and challenging to manage when diagnosed late. Chronic BSASD, after two years in a young patient, can result in fair functions.

**KEYWORDS**

acute, anterior, bilateral, chronic, epilepsy, shoulder dislocation

## 1 | INTRODUCTION

Bilateral shoulder dislocations are a rare occurrence.<fnref n="1" />⁻⁶ The two humeral heads dislocate from the scapular glenoid fossa in the same direction (bilateral symmetric shoulder dislocations or BSSD) or in different directions (bilateral asymmetric shoulder dislocations or BASD). There are three subtypes of BSSD (posterior,<fnref n="1" />,<fnref n="2" /> anterior,³ and inferior⁴). BASD are classified as anteroposterior (one side anterior and the other side posterior)⁵ or anteroinferior (one side anterior and the other side inferior).⁶ Dislocations are acute or recent when recognized in the 21 days from the trauma. After 21 days, dislocations are called chronic or old.

Bilateral symmetric posterior shoulder dislocations are the most common type since Cooper in 1839¹ and Myenter in 1902² reported the first cases. The literature found less commonly bilateral symmetric anterior shoulder dislocations (BSASD).⁷

We report two cases of BSASD, one acute and one chronic case, both after epileptic seizures. We discuss the epidemiology, etiology, mechanism of injury, treatment, and outcome

features through an extensive literature review of 133 BSASD reported cases.³,⁷⁻¹¹⁸

## 2 | CASE HISTORY

### 2.1 | Case 1

A 30-year-old male patient complained of bilateral shoulder pain at our ED. The patient woke up at night on the ground, a few minutes after falling from bed, but with no recollection of the fall. He had no prior history of epilepsy nor diabetes. An inaugural epileptic grand mal seizure was suspected. At admission, he presented with bilateral shoulder sulcus signs with an inability to rotate his arm internally (Figure 1). The neurovascular status was normal at both shoulders. Bilateral shoulder AP and Bloom-Obata views revealed bilateral subcoracoid anteromedial glenohumeral dislocation without associated fracture (Figure 2). Closed reduction of both shoulders was performed under general anesthesia. With the patient in the supine position,

<footnote n="1">¹Service d'Orthopédie-Traumatologie,
CHU Sourô Sanou (CHUSS), Nazi BONI
University, Bobo-Dioulasso, Burkina Faso</footnote>

<footnote n="2">²Service de chirurgie de la main, Hôpitaux
Universitaires de Strasbourg, Strasbourg,
France</footnote>

<footnote>This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.</footnote>

<footnote>© 2020 The Authors. *Clinical Case Reports* published by John Wiley & Sons Ltd.</footnote>
we applied vertical traction and external rotation of the arm to achieve reductions. The postreduction evaluation demonstrated stable joints and normal neurovascular status. We performed strict immobilization with bilateral arm slings for three weeks. The patient was long lost of view. He was re-evaluated 35 months later. At follow-up, radiographs demonstrated concentrically reduced glenohumeral joints and painless full range of motion (ROM) at both shoulders with a Constant score of 981.

## 2.2 | Case 2

A 27-year-old male farmworker presented two stiff shoulders, two years after an epileptic seizure. At the time of his initial injury, he was evaluated by traditional bonesetters who performed bilateral shoulder manipulations without anesthesia, after which he regained some mobility. For the subsequent two years, he was able to do some activities of daily living, including feeding, washing, and clothing himself. However, he was unable to do hard farming works. On our examination, he had bilateral shoulder sulcus signs with evidence of muscle atrophy in the scapular supraspinous and infraspinous fossae. Range of motion of the right shoulder was 85° of forwarding flexion, 30° of extension, 45° of abduction, 45° of cross-body adduction, 15° of external rotation, and 25° of internal rotation. Range of motion of the left shoulder was 85° of forwarding flexion, 30° of extension, 85° of abduction, 45° of cross-body adduction, 15° of external rotation, and 10° of internal rotation (Figure 3). The neurovascular status was normal. Medical imaging of shoulders included an AP and Bloom-Obata view radiographs, and a CT scan. There was a bilateral subcoracoid anteromedial dislocation of the humeral

head and an inverted neoglenoid-like joint. The neojoint was arranged between the scapular inferior glenoid rim and a large Hill-Sachs lesion (Figure 4). Despite poor Constant's scores (26.5/100 on the right side and 28.5/100 on the left), he was fully autonomous except for washing his upper back. We initially discussed an open reduction procedure. However, due to his successful adaptive shoulder function and his age, we recommended avoiding the surgery.

# 3 | DISCUSSION

## 3.1 | Epidemiology

From our analysis of the literature, the mean age of patients reported with BSASD was 40 years (SD = 18.43375) (Table 1). The youngest patient was 16 years old,¹⁰⁹ and the oldest was 91 years old.⁵⁰ The male-to-female ratio was 2.67. Due to pathognomonic "symmetric square shoulder aspect," referring to bilateral flattened shoulders, and inability to internally rotate either shoulder, dislocations are rarely missed in trauma condition. However, nontraumatic and involuntary muscular contraction (IMC) conditions can lead to missed dislocations.⁹,14,18,19,21,22,31,39,41,44,64,67,83,85,95,96,100,105,106,115 Acute injuries represented 85% of BSASD reported in the literature. Twelve of the 20 chronic BSASD reported in the literature occurred in IMC conditions. The mean delayed time for chronic dislocations was 22 weeks (SD = 34.07323) after injury. Our second case presented later than any of the cases reported in the literature (two years). The delayed presentation was a result of belief in traditional bonesetters, poverty, and the acceptable adaptive function of shoulders. Patients rarely had previous unilateral¹⁷,⁵⁶,⁶⁹,¹¹⁴ or bilateral⁵⁴,⁸²

<figure><img src="image_3.png" /><figcaption>**FIGURE 1** Clinical aspect of shoulders of an acute bilateral symmetric anterior shoulder dislocations in a 30-year-old man (Case 1) on the front (A), right-side (B), back (C), and left-side views. We noted bilateral square shoulders with arms fixed in abduction and external rotation</figcaption></figure>
<figure><img src="image_4.png" /><figcaption>**FIGURE 2** Shoulder radiographs (Case 1). AP (A) and Bernageau (B) views showed anteromedial subcoracoid displacement of both humeral heads</figcaption></figure>

shoulder dislocations. Unilateral¹⁷ and bilateral²⁹,⁵⁴,⁸² recurrences were reported in traumatic cases.

## 3.2 | Etiology and mechanism of injury

We sorted dislocations as traumatic, nontraumatic, and IMC-associated.⁷

The mean age of patients with *traumatic BSASD* reported in the literature was 45 years (SD = 19.81311). We identified five main mechanisms: indirect force, indirect traction, indirect lever, direct force, and complex mechanisms.

* *The indirect force mechanisms* are mainly an anteroposterior directed force applied through the extremity (55.3%) with the shoulder in flexion, abduction, and external

rotation (FABER). The classic circumstance is performing a bench press while weightlifting.²⁷,³²,⁴²,⁴⁶,⁶⁸,⁶⁹,⁸¹,⁹¹,⁹⁷,¹¹⁶ There is also the posterior-to-anterior force (39.5%) on the shoulder in hyperextension, abduction, and external rotation (EXABER). It commonly occurs when a patient is attempting to stop a backward fall from standing,⁷¹,⁸⁷ from a ladder,²⁹,⁵²,⁹⁸,¹¹⁷ a motorcycle,⁶³,⁹⁸ and a two-wheeled vehicle.⁵⁶ Rarely, dislocations are reported when an inferosuperior directed force (5.2%) is applied to the shoulder in FABER, occurring when falling or diving in a pool.³³,¹¹⁰

* *The traction mechanism* is either a superior or anterior traction force applied through the extremity with shoulders in FABER.¹¹,¹³,⁶⁶,⁷⁰ Hanging on a riding horse,⁶⁶ a motorcycle,¹³ and a curtain bar to prevent a fall⁷⁰ were typical circumstances. One case of lateral traction in a quarrel has been described.⁹⁵
<table><caption>TABLE 1 Bilateral symmetric anterior shoulder dislocation cases.<sup>3,7-118</sup></caption><thead><tr><th>Characteristic</th><th>Acute</th><th>Chronic</th><th>Total</th></tr></thead><tbody><tr><td>Mean age (y)</td><td>40</td><td>41</td><td>40 (37.35-43.87) CI<br>95%</td></tr><tr><td>Sex</td><td></td><td></td><td></td></tr><tr><td>Male</td><td>77</td><td>15</td><td>92</td></tr><tr><td>Female</td><td>29</td><td>5</td><td>34</td></tr><tr><td>Indetermined</td><td>7</td><td>0</td><td>7</td></tr><tr><td>Mechanism of injury</td><td></td><td></td><td></td></tr><tr><td>IMC-associated</td><td>38</td><td>12</td><td>50</td></tr><tr><td>Traumatic</td><td>68</td><td>4</td><td>72</td></tr><tr><td>Nontraumatic</td><td>3</td><td>2</td><td>5</td></tr><tr><td>Indetermined</td><td>4</td><td>2</td><td>6</td></tr><tr><td>Associated injuries (right/left shoulder)</td><td>45/51</td><td>8/12</td><td>53/63</td></tr><tr><td>Great tuberosity fracture</td><td>22/21</td><td>6/8</td><td>28/29</td></tr><tr><td>3-part fracture</td><td>6/4</td><td>0/0</td><td>6/4</td></tr><tr><td>4-part fracture</td><td>1/3</td><td>0/0</td><td>1/3</td></tr><tr><td>Humeral neck fracture</td><td>0/1</td><td>0/0</td><td>0/1</td></tr><tr><td>Inferior glenoid rim fracture</td><td>0/1</td><td>0/0</td><td>0/1</td></tr><tr><td>Coracoid process fracture</td><td>3/2</td><td>0/0</td><td>3/2</td></tr><tr><td>Axillary vessels</td><td>2/2</td><td>0/0</td><td>2/2</td></tr><tr><td>Brachial plexus lesion</td><td>9/13</td><td>2/4</td><td>11/17</td></tr><tr><td>Long biceps tendon interposition</td><td>1/2</td><td>0/0</td><td>1/2</td></tr><tr><td>Rotator cuff tears</td><td>1/2</td><td>0/0</td><td>1/2</td></tr><tr><td>None</td><td>50</td><td>5</td><td>55</td></tr><tr><td>Indetermined</td><td>12</td><td>3</td><td>15</td></tr><tr><td>Treatment (right/left shoulder)</td><td>95/95</td><td>16/17</td><td></td></tr><tr><td>None</td><td>0/0</td><td>3/3</td><td>3/3</td></tr><tr><td>Physiotherapy</td><td>0/0</td><td>0/0</td><td>0/0</td></tr><tr><td>Closed reduction</td><td>83/83</td><td>2/2</td><td>85/85</td></tr><tr><td>Open reduction</td><td>11/10</td><td>8/8</td><td>19/18</td></tr><tr><td>Arthroplasties</td><td>1/2</td><td>1/2</td><td>2/4</td></tr><tr><td>Refusal</td><td>0/0</td><td>1/1</td><td>1/1</td></tr><tr><td>Other (electrotherapy, Infrared ...)</td><td>0/0</td><td>1/1</td><td>1/1</td></tr><tr><td>Indetermined</td><td>18</td><td>3</td><td>21</td></tr><tr><td>Mean follow-up time (mo)</td><td>10.5</td><td>26.5</td><td>12.6</td></tr><tr><td>Instability</td><td>2/3</td><td>0/0</td><td>2/3</td></tr><tr><td>Recurrence</td><td>5/5</td><td>0/0</td><td>5/5</td></tr><tr><td>Range of motion (right/left shoulder)</td><td></td><td></td><td></td></tr><tr><td>Full</td><td>60/60</td><td>7/8</td><td>67/68</td></tr><tr><td>Loss of motion</td><td>4/4</td><td>3/3</td><td>7/7</td></tr><tr><td>Not determined</td><td>49</td><td>9</td><td>58</td></tr></tbody></table>

Abbreviation: IMC, involuntary muscular contractions.

* The lever mechanism was due to upper limb manipulations by bonesetters<sup>94</sup> or by helping a paratrooper to remove his equipment.<sup>111</sup>

* The direct hit on shoulders is less common in BSASD.<sup>22,47,55,92</sup> A directed blow such as fall on the back<sup>92</sup> or fall of a heavy object on a patient's back when leaning<sup>55</sup>
<figure><img src="image_5.png" /><figcaption>**FIGURE 3** Range of mobility demonstrations in a chronic (2 y) bilateral symmetric anterior shoulder dislocations in a 26-y-old man (Case 2)</figcaption></figure>

can drive the proximal humerus forward, resulting in a glenohumeral dislocation.

* *Complex mechanisms* associate two or more previously described mechanisms. They occur in high-energy traumas such as a plane crash⁹ and a tractor accident.²²

*Nontraumatic BSASD* is an exceptional condition. Inflammatory diseases such as rheumatoid arthritis⁴⁰,⁴⁴ have been associated with glenohumeral subluxations and dislocations, likely due to substantial capsular and ligamentous destruction.

*IMC* causes most bilateral shoulder dislocations.²,³ The review of IMC BSASD cases showed more males (4/5) with a mean age of 33 years (SD = 12.53 966). Muscular spasms can be caused by an epileptic seizure as seen in our cases,³,¹⁷,²²,²⁴,²⁶,³⁰,³⁹,⁵¹,¹⁰⁶,¹⁰⁷,¹⁰⁹,¹¹³,¹¹⁴ an electrocution,¹⁸,²⁰,⁷⁸,⁸⁵ toxins (opiate, alcohol, chloroquine, and insecticide),¹⁵,²³,³⁷,¹⁰⁴,¹¹⁵ a hypoglycemia,²⁸,⁴⁵,⁵⁴ emotionally charged circumstances (nightmare and fear of death),¹⁴,⁶⁷,⁷⁴ or from the vibrations of a digging machine.⁸⁹

## 3.3 | Associated injuries

Forty-three percent of BSASD were complicated, often bilaterally.

* Associated fractures accounted for two-thirds of these complicating injuries. Isolated greater tuberosity (GT) fractures represent three-quarters of fractures. Comminuted 3-part and 4-part proximal humerus fractures represented one-fifth of fractures. GT and multipart proximal humerus fractures were present in traumatic and IMC dislocations with

the same distribution. GT fractures were more common in traumatic indirect force dislocations⁸,³⁴,⁵²,⁶³,⁸⁷,⁹⁹,¹¹⁰,¹¹² and complex proximal humerus fractures in direct hit and complex mechanisms.⁵⁵ Nondisplaced associated coracoid process fractures seemed underestimated by the initial radiographs. Nondisplaced coracoid process fractures were often only found when early MRI was made.⁴⁵,⁸⁶,¹⁰¹

* Associated neurovascular injuries are less frequent (28.5%). When they do occur, the posterior and medial cords of the brachial plexus are often compressed,²²,²⁵,⁵² though sensorimotor function usually recovers with a good outcome. Four resolutions cases of axillary artery compression were reported in the literature.¹¹,⁶¹ Nervous status improves from week three and recovers in six months.⁵²,⁷⁰,⁹⁴ Traction mechanisms put the highest risk on the neurovascular structures.¹¹,⁹¹ Neurovascular compressions must be recognized and addressed promptly to avoid sequelae.

* The others reported associated injuries are *rotator cuff tears* in GT-free fractures,²⁹ *the interposition of the long biceps tendon* in complex proximal humerus fractures,³⁴ and *osseous Bankart lesions*.³⁷

The chronicity enlarges the Hill-Sachs notch as it becomes the neoglenoid fossa.

## 3.4 | Treatment and outcome

Acute BSASD are mainly managed by closed reduction (CR).⁷,⁸,¹³,¹⁴,¹⁷,²²,²⁴,²⁷-³⁰,³²,³³,³⁵,⁴²,⁴⁵,⁴⁷-⁵²,⁵⁴,⁵⁶,⁵⁸,⁶⁰,⁶²,⁶³,⁶⁵,⁶⁶,⁶⁸-⁷²,⁷⁴-⁷⁷,⁸⁰-⁸²,⁸⁴,⁸⁶-⁸⁸,⁹⁰-⁹⁴,⁹⁶-⁹⁹,¹⁰¹-¹⁰⁴,¹⁰⁷-¹¹³,¹¹⁶,¹¹⁸ The presence of an associated lesion often necessitates operative management. Displaced GT
<figure><img src="image_6.png" /><figcaption>**FIGURE 4** Shoulder radiographs and CT scan (Case 2). Between inferior glenoid rims and posterior Hill-Sachs lesion (arrows) are arranged neoglenoid joints</figcaption></figure>

fractures were managed by plate and screws with washers⁹⁶,⁹⁹; anchors were used for rotator cuff tenodesis⁹⁹,¹¹⁰; and some authors performed primary Bankart-like procedures.¹⁰² Complex fracture-dislocations require extrication of the long biceps tendon³⁴ and open reduction and internal fixation (ORIF).³⁴,³⁷,⁴⁵,⁵⁵,⁷³,⁸⁵ Nagi et al³⁴ choose primary hemiarthroplasty in a 4-part proximal humerus fracture-dislocation in a 49-year-old patient, though persistent neurovascular complications impaired the final outcome.²²

In chronic BSASD, CR has been reported effective until week 4.⁹,²⁰,²²,⁶⁴,¹⁰⁵ Other authors have undertaken open reduction⁹⁵,¹⁰⁵,¹¹⁵ and associated anterior buttress¹⁰⁰ or Bankart¹⁰⁶ procedures with some good outcomes. In young patients, Hill-Sachs lesions must be filled if the surgeon opts for an open reduction procedure. Bilateral hemiarthroplasty⁴¹ and

reverse total shoulder arthroplasty⁸³ should be proposed to patients older than 60 years. Like our second case, abstaining from surgery is a reasonable option for a young patient with satisfied adaptive functions.⁸³,⁹⁵

4 | CONCLUSION

The literature review showed sporadic cases of BSASD. Caution must be taken in epileptic and diabetes seizures to diagnose and treat patients promptly. Patient education, health insurance, and policy initiatives to improve access to health facilities are essential, especially in the low-resource setting. It will avoid delayed presentation of chronic shoulder dislocations.
## ACKNOWLEDGMENTS

The authors thank Dr Kiran Agrawal-Harding, Dr Adam's N Ouédraogo, Dr Mamadou Niang, and all teams of emergency department and orthopedic department of the CHU Sourô Sanou for their help in the case management. Published with written consent of the patient.

## CONFLICT OF INTEREST

All the authors declare that they have no conflict of interest.

## AUTHORS' CONTRIBUTION

DM: managed the patients, reviewed the literature, performed analyses, and wrote the manuscript. DSRK: managed the patients and performed the last evaluation. MS, PWD, and PL: reviewed the manuscript.

## ETHICAL APPROVAL

The patients were informed and consented to their data being collected and anonymized for education and scientific purpose. Unwritten verbal authorizations from both patients were obtained.

## DATA AVAILABILITY STATEMENT

The datasets used during the current study are available from the corresponding author on reasonable request.

## ORCID

Malick Diallo ID https://orcid.org/0000-0003-3484-2268

Philippe Liverneaux ID https://orcid.

org/0000-0002-5509-8995

## REFERENCES

1. Cooper SA. *A Treatise on Dislocations, and on Fractures of the Joints*. Boston, MA: Wells and Lilly; 1825.

2. Myenter H. Subacromial dislocation from muscular spasm. *Ann Surg*. 1902;36:117-119.

3. Sargent P. Case of bilateral dislocation of shoulder with marked muscular wasting. *Proc R Soc Med*. 1909;2(Neurol_Sect):37.

4. Murrard J. Un cas de luxatio erecta de l'épaule double et symetrique. *Rev Orthop*. 1920;7:423-429.

5. Aufderheide TP, Frascone RJ, Cicero JJ. Simultaneous bilateral anterior and posterior shoulder dislocations. *Am J Emer Med*. 1985;3(4):331-333.

6. Fung DA, Menkowitz M, Chern K. Asymmetric bilateral shoulder dislocation involving a luxatio erecta dislocation. *Am J Orthop*. 2008;37(5):97-98.

7. Ballesteros R, Benavente P, Bonsfills N, Chacón M, García-Lázaro FJ. Bilateral anterior dislocation of the shoulder: review of seventy cases and proposal of a new etiological-mechanical classification. *J Emerg Med*. 2013;44(1):269-279.

8. Tirelli S. Lussazione traumatica bilaterale delle spalle. *Policlinico (Sez Prat)*. 1932;39:1049-1051.

9. Lynn TA, Peterson LT. Bilateral simultaneous dislocation of the shoulders: report of a case. *J Bone Joint Surg*. 1946;28(1):161-163.

10. Jekic M. Rare case of bilateral shoulder dislocation. Paper presented at: Langenbecks Archiv fur Chirurgie; 1973.

11. Noczyński L, Pawlowski A, Makowski Z, Lubowicz B. Bilateral anterior dislocation of the shoulder with vascular and neurologic sequelae. *Chir Narzadow Ruchu Ortop Pol*. 1973;38(1):31-33.

12. Jeleń J. Simultaneous traumatic dislocation of both shoulders. *Chir Narzadow Ruchu Ortop Pol*. 1974;39(5):591.

13. McFie J. Bilateral anterior dislocation of the shoulders: a case report. *Injury*. 1976;8(1):67-69.

14. Yadav S. Bilateral simultaneous fracture-dislocation of the shoulder due to muscular violence. *J Postgrad Med*. 1977;23(3):137.

15. Biró A. Bilateral scapulohumeral luxation, a complication of aldrin poisoning. *Rev Chir Oncol Radiol O R L Oftalmol Stomatol Chir*. 1978;27(6):449.

16. Onabowale B, Jaja M. Unreduced bilateral synchronous shoulder dislocations. A case report. *Niger Med J*. 1979;9(2):267-271.

17. Segal D, Yablon IG, Lynch JJ, Jones RP. Acute bilateral anterior dislocation of the shoulders. *Clin Orthop Relat Res*. 1979;140:21-22.

18. Carew-McColl M. Bilateral shoulder dislocations caused by electric shock. *Br J Clin Pract*. 1980;34(8-9):251.

19. Unrunbaev D. Case of the reduction of an inveterate bilateral dislocation of the humerus in a female patient with scapular and peroneal myopathy. *Ortop Travmatol Protez*. 1980;10:42-43.

20. Salem M. Bilateral anterior fracture-dislocation of the shoulder joints due to severe electric shock. *Injury*. 1983;14(4):361-363.

21. Tanzman M, Segev Z, Kaufman B. Missed bilateral anterior dislocation of the shoulder following convulsions. *Harefuah*. 1983;105(9):266.

22. Brown R. Bilateral dislocation of the shoulders. *Injury*. 1984;15(4):267-273.

23. Hartney-Velazco K, Velazco A, Fleming L. Bilateral anterior dislocation of the shoulder. *South Med J*. 1984;77(10):1340-1341.

24. Sadhra K. Unusual dislocations associated with epileptic fits. *BMJ (Clin Res Ed)*. 1984;288(6418):681.

25. Paley D, Love T, Malcolm B. Bilateral anterior fracture-dislocation of the shoulder. With brachial plexus and axillary artery injury. *Orthop Rev*. 1986;15(7):443-446.

26. Sciammarella JJ. Bilateral shoulder dislocations. *Ann Emerg Med*. 1986;15(6):763.

27. Jones M. Bilateral anterior dislocation of the shoulders due to the bench press. *Br J Sports Med*. 1987;21(3):139.

28. Litchfield J, Subhedar V, Beevers D, Patel H. Bilateral dislocation of the shoulders due to nocturnal hypoglycaemia. *Postgrad Med J*. 1988;64(752):450-452.

29. Mehta MP, Kottamasu SR. Anterior dislocation of the shoulders with bilateral brachial plexus injury. *Ann Emerg Med*. 1989;18(5):589-591.

30. Ribbans W. Bilateral anterior dislocation of the shoulder following a grand-mal convulsion. *Br J Clin Pract*. 1989;43(5):181-182.

31. Costigan P, Binns M, Wallace W. Undiagnosed bilateral anterior dislocation of the shoulder. *Injury*. 1990;21(6):409.

32. Maffulli N, Mikhail H. Bilateral anterior glenohumeral dislocation in a weightlifter. *Injury*. 1990;21(4):254-256.

33. Mathis RD. Bilateral shoulder dislocation: an unusual occurrence. *J Emerg Med*. 1990;8(1):41-43.

34. Nagi O, Dhillon M. Bilateral anterior fracture-dislocation of the shoulders. *J Orthop Trauma*. 1990;4(1):93-95.
35. Velkes S, Lokiec F, Ganel A. Traumatic bilateral anterior dislocation of the shoulders: a case report in a geriatric patient. *Arch Orthop Trauma Surg.* 1991;110(4):210-211.

36. Lal M, Sharma A. Simultaneous bilateral anterior glenohumeral dislocation: rare entity with unique mechanism: a case report with review of literature. *Int J Orthop.* 2019;5(3):515-518.

37. Markel DC, Blasier RB. Bilateral anterior dislocation of the shoulders with greater tuberosity fractures. *Orthopedics.* 1994;17(10):945-949.

38. Marty B, Simmen H, Käch K, Trentz O. Bilateral anterior shoulder dislocation fracture after an epileptic seizure. A case report. *Der Unfallchirurg.* 1994;97(7):382-384.

39. Gynning JB, Hansen H. Bilateral anterior shoulder luxation—an overlooked case. *Ugeskr Laeger.* 1995;157(16):2327-2328.

40. Gaździk T. A case of recurrent bilateral shoulder dislocation in a patient with Felty's syndrome. *Chir Narzadow Ruchu Ortop Pol.* 1996;61(6):531-533.

41. Thomas D, Graham G. Missed bilateral anterior fracture-dislocations of the shoulder. *Injury.* 1996;27(9):661-662.

42. Cresswell T, Smith R. Bilateral anterior shoulder dislocations in bench pressing: an unusual cause. *Br J Sports Med.* 1998;32(1):71-72.

43. Dinopoulos H, Giannoudis P, Smith R, Matthews S. Bilateral anterior shoulder fracture-dislocation. *Int Orthop.* 1999;23(2):128-130.

44. Mihai R, Dixon JH. Bilateral atraumatic dislocation of the shoulder. *J Accid Emerg Med.* 1999;16(6):460.

45. Cottias P, Yl B, Jeanrot C, Imbert P, Huten D, Masméjean EH. Fractured coracoid with anterior shoulder dislocation and greater tuberosity fracture—report of a bilateral case. *Acta Orthop Scand.* 2000;71(1):95-97.

46. Esenkaya I, Tuygun H, Türkmen IM. Bilateral anterior shoulder dislocation in a weight lifter. *Phys Sportsmed.* 2000;28(3):93-100.

47. Ng A, Rix T, Roy B. Acute bilateral anterior dislocations of the shoulders. *Ulster Med J.* 2000;69(2):171.

48. Martínez A, Herrero L, Herrera A. Bilateral anterior shoulder dislocation due to electric shock. *Eur J Orthop Surg Traumatol.* 2001;11(2):121-122.

49. Yuen M-C, Tung W-K. The use of the Spaso technique in a patient with bilateral dislocations of shoulder. *Am J Emerg Med.* 2001;19(1):64-66.

50. Dunlop C. Bilateral anterior shoulder dislocation. A case report and review of the literature. *Acta Orthop Belg.* 2002;68(2):168-170.

51. Echarri SA, Santesteban EE, Irigoyen J, Aldaz BJ. Anterior bilateral scapulohumeral luxation after convulsive crisis. *Aten Primaria.* 2002;30(2):134.

52. Devalia Kailash L, Peter V. Letter To Editor-Bilateral post-traumatic anterior shoulder dislocation. *J Postgrad Med.* 2005;51(1):72-73.

53. Okamura K, Seino H, Yamamoto N, Hirose T, Goroku T, Horigome K. Simultaneous bilateral anterior dislocation of the shoulder caused by skiing accident -a case report in a teenager. *JPN J Orthop Sports Med.* 2004;23:324-328.

54. Özçelik A, Dinçer M, Çetinkanat H. Recurrent bilateral dislocation of the shoulders due to nocturnal hypoglycemia: a case report. *Diabetes Res Clin Pract.* 2006;71(3):353-355.

55. Sharma L, Pankaj A, Kumar V, Malhotra R, Bhan S. Bilateral anterior dislocation of the shoulders with proximal humeral fractures: a case report. *J Orthop Surg.* 2005;13(3):303-306.

56. Singh S, Kumar S. Bilateral anterior shoulder dislocation: a case report. *Eur J Emerg Med.* 2005;12(1):33-35.

57. Sreesohb K, Chacko B. An unusual case of bilateral anterior dislocation of shoulder. *J Orthop.* 2005;2(4):e6.

58. Ngim N, Udorroh E, Udosen A. Acute bilateral anterior shoulder dislocation following domestic assault—case report. *West Afr J Med.* 2006;25(3):256-257.

59. Sarrafan M, Mehdinasab M, Aabdolhossein S. Traumatic bilateral anterior dislocation of shoulder (report of one case). *Iran J Orthop Sur.* 2006;5(1):38-40.

60. Bellazzini MA, Deming DA. Bilateral anterior shoulder dislocation in a young and healthy man without obvious cause. *Am J Emerg Med.* 2007;25(6):734.e1-734.e3.

61. Lin C-Y, Chen S-J, Yu C-T, Chang I-L. Simultaneous bilateral anterior fracture-dislocation of the shoulder with neurovascular injury: report of a case. *Int Surg.* 2007;92(2):89-92.

62. O'Connor-Read L, Bloch B, Brownlow H. A missed orthopaedic injury following a seizure: a case report. *J Med Case Rep.* 2007;1(1):20.

63. Abalo A, Dossim A, Songné B, Ayouba G. Luxation antérieure bilatérale des épaules: a propos d'un cas. *Chir Main.* 2008;27(2):118-121.

64. Lasanianos N, Mouzopoulos G. An undiagnosed bilateral anterior shoulder dislocation after a seizure: a case report. *Cases J.* 2008;1(1):342.

65. Siwach R, Singh R, Rohilla R, Sangwan SS. Bilateral anterior dislocation of the shoulder—a case report and review of the literature. *Injury Extra.* 2008;39(12):394-397.

66. Turhan E, Demirel M. Bilateral anterior glenohumeral dislocation in a horse rider: a case report and a review of the literature. *Arch Orthop Trauma Surg.* 2008;128(1):79-82.

67. Abdulkadir AY, Adesiyun O, Jimoh OR, Amole A. Chronic bilateral anterior shoulder dislocation. *S Afr Med J.* 2009;99(5):313.

68. Bouras Y, Elandaloussi Y, Nadil MA, et al. Luxation antérieure bilatérale des épaules chez le bodybuilder (à propos d'un cas). *J Traumatol Sport.* 2009;26(4):247-249.

69. Felderman H, Shih R, Maroun V. Chin-up-induced bilateral anterior shoulder dislocation: a case report. *J Emerg Med.* 2009;37(4):400-402.

70. Kalkan T, Demirkale I, Ocguder A, Unlu S, Bozkurt M. Bilateral anterior shoulder dislocation in two cases due to housework accidents. *Acta Orthop traumatol turc.* 2009;43(3):260-263.

71. Botha A, Du Toit A. Bilateral anterior shoulder dislocation: a case report of this rare entity. *SA Orthop J.* 2010;9(4):68-70.

72. Mofidi M, Kianmehr N, Farsi D, Yazdanpanah R, Majidinezhad S, Asadi P. An unusual case of bilateral anterior shoulder and mandible dislocations. *Am J Emerg Med.* 2010;28(6):745.e1-745.e2.

73. Porecha MM, Parmar DS. Bilateral anterior fracture-dislocation shoulder: a case report with a review of the literature. *Eur J Orthop Surg Traumatol.* 2011;21(1):43-46.

74. Rouhani A, Zonooz KA, Aghdam HA. An unusual cause of bilateral anterior shoulder dislocation. *Pak J Med Sci.* 2010;26(4):976-977.

75. Thakur A, Gupta R, Kotwal V, Arora D. A rare case of bilateral anterior dislocation of the shoulder. *J Clin Diagnost Res.* 2010;4(6):3567-3569.

76. Silva LP, Sousa CV, Rodrigues E, Alpoim B, Leal M. Bilateral anterior glenohumeral dislocation: clinical case. *Rev Brasil Ortop.* 2011;46(3):318-320.

77. Tripathy SK, Sen RK, Aggarwal S, Dhatt SS, Tahasildar N, Shuang-ming S. Simultaneous bilateral anterior shoulder
dislocation: report of two cases and review of the literature. *Chin J Traumatol.* 2011;14(5):312-315.

78. Bachhal V, Goni V, Taneja A, Shashidhar B. Bilateral four-part anterior fracture-dislocation of the shoulder: a case report and review of literature. *Bull NYU Hosp Jt Dis.* 2012;70(4):268.

79. Bilsel K, Erdil M, Elmadag M, Ceylan HH, Celik D, Tuncay I. A rare complication of tuberculous meningitis pediatric anterior glenohumeral instability. *Case Rep Orthop.* 2012;2012:1-4.

80. Dlimi F, Rhanim A, Lahlou A, et al. Bilateral anterior dislocation of the shoulders at the start of a backstroke competition. *J Orthopaed Traumatol.* 2012;13(1):47-49.

81. Moughty AM, O'Connor G. Bilateral anterior shoulder dislocation. *N Engl J Med.* 2012;367(8):e12.

82. Patil MN. A case of simultaneous bilateral anterior shoulder dislocation. *J Orthop Case Rep.* 2013;3(2):35-37.

83. Sugathan HK, Radha S, Harrison JW. Chronic bilateral anterior shoulder dislocation—case report and review of literature. *Eur Orthop Traumatol.* 2012;3(4):227-229.

84. Suryavanshi A, Mittal A, Dongre S, Kashyap N. Bilateral anterior shoulder dislocation with symmetrical greater tuberosity fracture following Seizure. *J Orthop Case Rep.* 2012;2(1):28.

85. Kubiak G, Fabiś J. Clinical improvement after two years one stage bilateral open reduction of chronic anterior shoulder dislocations with internal fixation of greater tuberosity fractures. Case study. *Ortop Traumatol Rehabil.* 2013;15(2):175-181.

86. Taneja AK, Neto LP, Skaf A. Bilateral anterior glenohumeral dislocation and coracoid processes fracture after Seizure: acute MRI findings of this rare association. *Clin Imaging.* 2013;37(6):1131-1134.

87. Meena S, Saini P, Singh V, Kumar R, Trikha V. Bilateral anterior shoulder dislocation. *J Nat Sci Biol Med.* 2013;4(2):499.

88. Nourredine H, El Sayad M, Gull S, Davies AP. Bilateral anterior shoulder dislocation. *Case Rep.* 2013;2013 apr 29 1: bcr2012008308.

89. Manoharan G, Singh R, Ahmed B, Kathuria V. Acute spontaneous atraumatic bilateral anterior dislocation of the shoulder joint with Hill-Sachs lesions: first reported case and review of literature. *Case Rep.* 2014;2014(jun 03 1): bcr2013202847.

90. Shiber JR, Diaz JA, Bohsali KI. Bilateral anterior shoulder dislocations due to seizure. *Trop Med Surg.* 2014;2(1):160.

91. Siu YC, Lui TH. Bilateral anterior shoulder dislocation. *Arch Trauma Res.* 2014;3(4):e18178.

92. Ali N, Bhat A, Bangroo F, Dhanda M, Sharma S. Simple bilateral anterior shoulder dislocation: a case report and review of the literature. *SA Orthop J.* 2015;14(3):47-51.

93. Auerbach B, Bitterman A, Mathew C, Healy III W. Bilateral shoulder dislocation presenting as a unilateral shoulder dislocation: case report. *J Am Osteopath Assoc.* 2015;115(8):514-517.

94. Chen C-L, Chiu S-L, Chu C-L, Lan S-J. Tragic result of traditional Chinese medicine manipulation: an unusual case report of bilateral anterior shoulder dislocations. *BMC Complement Altern Med.* 2015;15(1):1-4.

95. Chouapalle R, Chokkarapu R, Kolluri RK, et al. A case of neglected bilateral anterior shoulder dislocation: a rare entity with unusual mechanism of injury. *Case Rep Orthop.* 2015;2015:1-3.

96. Dwidmuthe Samir C, Goel A, Agrawal U, Sapre V. Bilateral anterior fracture-dislocation of shoulder joint-A rare presentation. *Int J Orthop.* 2015;1(2):4-6.

97. Amir MA, Alenazi B, Wyse RK, et al. Neglected bilateral posterior shoulder fracture-dislocation in an uncontrolled seizure patient. *Pak J Med Sci.* 2015;31(4):1018.

98. Koufagued K, Chafry B, Bouabid S, Chagar B. Pure bilateral anterior dislocations of the shoulder of special mechanism: report of two cases. *Pan Afr Med J.* 2015;22:178.

99. Madi S, Pandey V, Acharya K, Ramakrishna KPP. A rare injury to a rear seat passenger: bilateral fracture-dislocation of the shoulders. *Case Rep.* 2015;2015(jun 11 1): bcr2015209992.

100. Poggetti A, Castellini I, Neri E, Marchettil S, Lisanti M. Atraumatic bilateral neglected anterior shoulder dislocation: case report of a Jehovah's Witness 28-year-old male affected by iron-deficiency anemia and treated with bilateral Latarjet procedure. *J Orthop Case Rep.* 2015;5(3):81.

101. Sachit M, Shekhar A, Shekhar S. Acute spontaneous atraumatic bilateral anterior dislocation of the shoulder joint with Hill-Sachs lesions: a rare case. *J Orthop Case Rep.* 2015;5(1):55.

102. Şanel S, Şencan S, Öçgüder A, Solakoğlu C. Bilateral, locked, recurrent anterior shoulder dislocation: case report. *Eklem Hastalik Cerrahisi.* 2015;26:52-55.

103. Wheelton A, Dowen D. A case of bilateral anterior glenohumeral dislocation following first-time Seizure. *J Orthop Case Rep.* 2015;5(2):38.

104. Martin AN, Tsekes D, White WJ, Rossouw D. Chloroquine-induced bilateral anterior shoulder dislocation: a unique aetiology for a rare clinical problem. *Case Rep.* 2016;2016: bcr2015214292.

105. Upasani T, Bhatnagar A, Mehta S. Bilateral neglected anterior shoulder dislocation with greater tuberosity fractures. *J Orthop Case Rep.* 2016;6(2):53.

106. Ahmad K, Ayaz SB, Khalil HB, Matee S. Bilateral spontaneous anterior shoulder dislocation: a missed orthopedic injury mistaken as proximal neuropathy. *Chin J Traumatol.* 2017;20(6):370-372.

107. Diouf A, Gueye A. Three cases of bilateral anteromedial dislocations of the shoulder. *Int J Orthop.* 2017;3(4):679-682.

108. Park TD, Enyart JM, Goyke TE, Greenberg MR. An unusual case of bilateral anterior shoulder dislocations. *Radiol Case Rep.* 2018;13(1):197-199.

109. Rudy BS, Hennrikus WL. Bilateral anterior shoulder dislocation. *J Am Acad PAs.* 2017;30(7):25-27.

110. Schneider KN, Schliemann B, Manz SM, Buddhdev PK, Ahlbäumeri G. Bilateral anterior shoulder dislocation in the elderly-a case report and review of the literature. *J Orthop Case Rep.* 2017;7(5):42.

111. Oron A, Netzer N, Rosinsky P, Arama Y, Behrbalk E. Bilateral anterior shoulder dislocation in a paratrooper: a case report. *Clin Res Orthop.* 2018;1(1):1-2.

112. Da SC, Tinto S, Korsaga AS, et al. Bilateral anterior shoulder fracture-dislocation: about a case. *Open J Orthop.* 2018;8(05):183-189.

113. Joseph J, Nguyen N, Gruzman D, Boutin A, Olsen D. No sweat! Bilateral shoulder reduction using a modified Davos technique. *Clin Pract Cases Emerg Med.* 2019;3(1):40-42.

114. Ibrahima F, Guifo LM, Handy ED, Nana Chunteng T, Sosso MA. Recurrent bilateral anterior simultaneous dislocation of the shoulder following epileptic seizures: a rare lesional association. *Int J Orthop Res Ther.* 2017;1(1):6-9.
115. Dodds SD, Medvecky MJ. Chronic bilateral locked anterior shoulder fracture-dislocations. *Am J Orthop*. 2008;37(7):364-368.

116. de la Fuente FA, Hoyte C, Bryant SM. Push-ups may be hazardous to your health: an atraumatic etiology for bilateral shoulder dislocation. *Am J Emerg Med*. 2008;26(1):116.e113-116.e114.

117. Jarvela T, Salmela M. Bilateral anterior shoulder dislocation and fracture of the humeral neck combined with a large rotator cuff tear on left side. *SICOT Online Rep*. 2003;e08.

118. Yashavantha Kumar C, Nalini KB, Lalit M, Prashanth N. Bilateral traumatic anterior dislocation of shoulder - a rare entity. *J Orthop Case Reports*. 2013;3(1):23-25.

**How to cite this article:** Diallo M, Soulama M, Kaboré DSR, Dakouré PWH, Liverneaux P. Bilateral anterior shoulder dislocations: A review of two cases and the relevant literature. *Clin Case Rep*. 2020;8:3378–3387. https://doi.org/10.1002/ccr3.3351