Case of bilateral non-traumatic posterior fracture-dislocation of humeral heads

Posterior shoulder dislocation is a rare pathology, accounting for 1,5% to 5% of all dislocation cases observed in this area. The combination of a posterior dislocation with a humeral fracture is an even more unusual clinical occurrence. Clinical case: Patient R., a 54-year-old man, presented with complaints of pain and limited range of motion in both shoulder joints, which had suddenly developed about 3 weeks ago following a seizure that occurred after an episode of alcohol consumption. Computed tomography revealed bilateral posterior fracture-dislocations of both humeral bones. Bilateral posterior shoulder fracture-dislocations are extremely rare pathologies, most commonly associated with epileptic seizures or severe trauma. The main mechanisms of injury include direct trauma and excessive muscle effort. The diagnosis of such injuries is often delayed; however, a thorough patient history can raise suspicion of this pathology. Radiography is the key diagnostic method with pathognomonic signs, but computed tomography is preferred for better visualization. Treatment includes both conservative and surgical methods, depending on the severity of the injury and the patient's condition. Despite advances in imaging techniques, the diagnosis of posterior fracture-dislocation is often delayed by more than 6-12 months, which can significantly affect patient management strategies. A careful history-taking and timely radiological imaging can lead to an accurate diagnosis, thereby reducing the risk of recurrent instability.