Bilateral Inferior Shoulder Dislocation

A 42-year-old male with a history of multiple shoulder dislocations presented to the emergency department via emergency medical services with both arms locked above his head, stating that he had been jumped at a bar and had since been unable to move his arms. A single anteroposterior chest radiograph (Figure) demonstrates bilateral inferior shoulder dislocations. The humeral head (white arrow) is displaced from the glenoid (yellow arrow) on each side. Inferior shoulder dislocations are the rarest of all glenohumeral joint dislocations, accounting for less than 1%; and bilateral inferior dislocations are therefore extremely infrequent. The classic presentation is the patient whose arm is locked above his head in a hyper-abducted fashion. The inferior dislocation must first be converted to an anterior dislocation by slowly adducting the arm. The anterior dislocation can then be reduced using routine maneuvers. Southern Illinois University School of Medicine, Division of Emergency Medicine, Department of Surgery, Springfield, Illinois