A rare case of bilateral antero-internal shoulder dislocation in a judo player: a case study and review of the literature

Pure anterior bilateral shoulder dislocations are rare clinical features, especially in traumatic forms. They are most often posterior, occurring during an epileptic seizure. Few cases are described in the literature, and the mechanism varies from case to case. We report a specific case of pure bilateral anterior shoulder dislocation in a 29-year-old judo player following an accident during his training and discuss the circumstances, mechanism, treatment, and prognosis.

decollement epiphysaire traumatique de l'estremite inferieure du femur a propos de 22 cas

The epiphyseal detachment of the lower extremity of the femur is a relatively rare lesion but severe as it is the cause of problems. The most frequent etiology is the highway accident: this shows the violence of the causal traumatism. It supervenes especially in the adolescent with neat male predominance. The diagnosis, generally easy is based on the clinical examination but especially on the radiographies: Radiography of the reached knee in strict face, radiography of the reached knee in strict profile, with at less doubt, comparative photographs. There are 5 stages of lesions according to SALTER and HARRIS' anatomopathologic classification. For the stages I, II, III and IV, the diagnosis is easy, whereas the stage V is still the most often unknown until the appearance of the sequelae. We notice that the stage II is, from afar the most frequent. However, inspite of the easiness of SALTER and HARRIS' classification, some elements are still dark and the prognosis of stages I and II is bad. In this case, the explanation would be physiopathologic according to SHAPIRO. The treatment must be undertaken emergently, and based on a reduction as perfect as possible whatever is orthopedic or bloodstained. A radiographic supervision, by telemensuration of all the femur is necessary during the period of setting to discolose an eventual secondary detachement. However, the sequelae are still unforeseeable and essentially the disorders of growth that can result in major handicap. This requires a radioclinical supervision in these patients until the end of their growth, in order to detect the sequelae and to treat them if necessary. The prognosis is based on several factors: the age of the patient, the epiphyseal vascularization, the nature of detachement, the quality of the therapeutic supervision. Thinking about the epiphyseal detachement in front of any traumatism of the knee, careful reading of the radiographies, an adjusted and well guided treatment, a regular radioclinical supervision until the end of growth must permit to improve the prognosis