bilateral shoulder dislocation are most commonly posterior type . these are most commonly due to seizure disorder and electrocution . to best of our knowledge there are only few cases of similar kind are reported in literature . we hereby report a interesting case of posttraumatic , bilateral anterior dislocation of shoulder without associated fracture in a 45 old women without any predisposing pathoanatomy . a 45-year - old women presented to casualty with sudden onset of pain and restriction of movement in both shoulders fallowing trauma . immediately post trauma she had severe pain and restriction of both shoulders . on examination arms were abducted and externally rotated . there was loss of round contour of shoulder with increased vertical diameter of axilla anteriorly . bilateral traumatic anterior shoulder dislocations are rare and are seen as a result of unique mechanism of injury . in our case patient bilateral shoulder dislocations are usually posterior type and are almost pathognomonic of seizure disorder or electrocution . though anterior dislocation of shoulder is commonest bilateral simultaneous dislocation is very rare[1 - 7 ] . we hereby report a case of posttraumatic , bilateral anterior dislocation of shoulder without associated fracture in a 45 old women . a 45-year - old women presented to lok nayak hospital , new delhi , india in august 2010 with sudden onset of pain and restriction of movement in both shoulders fallowing trauma . she had no history of seizure , epilepsy , previous shoulder dislocation or instability in other joints . on examination arms . there was loss of round contour of shoulder with increased vertical diameter of axilla anteriorly . radiological examination revealed bilateral anterior dislocation of the shoulders without any associated fractures(figure 2 ) . radiograph showing bilateral shoulder dislocation concentric reduction of bilateral shoulder joint achieved closed reduction done by milch technique after intraraticular lignocaine injection . majority of the bilateral shoulder dislocations are of posterior type most commonly seen during convulsion , electric shock or hypoglycaemic seizures . posterior type is common in these conditions due to violent contractions of the muscles of the shoulder girdle [ 8 - 10 ] . unlike bilateral occurrence of anterior shoulder dislocation is rare because of the fact that one extremity takes the brunt of the impact . to best of our knowledge only three cases of bilateral anterior dislocations are reported in literature . in two of the three cases reported were sequential , one sided followed by contra lateral side dislocation . in our case impact is same on both shoulders at the same time . the mechanism of anterior dislocation is forced extension , abduction and external rotation of the arm . in our case mechanism of injury mechanism of injury , systemic disease and associated fractures in various similar cases is depicted in table 1 . croswell and smith reported a case of bilateral anterior dislocation of the shoulder without any fractures in a bench - pressing athlete . in an unusual mechanism of injury weight on the bar forced his arms into hyperextension in the mid - abducted position . the humeral shaft gradually pivoted on the bench and the humeral heads were slowly dislocated interiorly by the weight of the bar . sandeep s and sudhir k reported a case of sequential bilateral anterior dislocation in which the left shoulder dislocated first due to trauma followed by atraumatic dislocation of the right shoulder . sreesobh k v et al reported a case where atraumatic right shoulder dislocation was followed by traumatic dislocation of the left . this type of dislocation involves a unique type of mechanism injury and in our case it was fall on pointed elbow causing forced extension . traumatic bilateral anterior dislocations without any pathologic lesion are very rare with only few cases reported in literature .
introduction : bilateral shoulder dislocation are most commonly posterior type . these are most commonly due to seizure disorder and electrocution . anterior shoulder dislocations occurring bilaterally without any predisposing factors 
 are very rare . 
 these types of injuries are due to trauma with a unique mechanism of injury . 
 to best of our knowledge there are only few cases of similar kind are reported in literature . 
 we hereby report a interesting case of posttraumatic , bilateral anterior dislocation of shoulder without associated fracture in a 45 old women without any predisposing pathoanatomy.case report : a 45-year - old women presented to casualty with sudden onset of pain and restriction of movement in both shoulders fallowing trauma . 
 immediately post trauma she had severe pain and restriction of both shoulders . on examination arms were abducted and externally rotated . 
 bilateral shoulder movements were painful and restricted . 
 there was loss of round contour of shoulder with increased vertical diameter of axilla anteriorly . 
 radiological examination revealed bilateral anterior dislocation of the shoulders without any associated fractures . 
 closed reduction done by milch technique after intraraticular lignocaine injection . 
 mri of bilateral shoulder showed no pathological lesion . 
 both shoulders were immobilized with a shoulder immobilizer for three weeks.conclusion:most of the bilateral shoulder dislocations are posterior type seen in seizure disorders . 
 bilateral traumatic anterior shoulder dislocations are rare and are seen as a result of unique mechanism of injury . in our case patient 
 had a fall on her elbows causing forced extension . 
 if diagnosed and treated promptly completely normal function of the shoulders can be restored .