Orthopaedic emergency revealing a neurological disorder

Many systemic disorders present with Orthopedic manifestations. One such rare entity is posterior dislocation of shoulder. A 28 year old student was brought in with pain and inability to use both arms when he woke up in the morning. The diagnosis was bilateral posterior dislocation of shoulder following Grand Mal epilepsy. Emergency closed reduction and percutaneous K wire fixation was done under general anesthesia and innovative waist cast was applied to immobilize both shoulders in flexion, abduction and external rotation. Treatment for epilepsy was continued. After one week, custom made orthosis was used for shoulder immobilisation, K wires were removed at four weeks. With physiotherapy, patient regained full range of movements by 10 weeks. This is a rare condition and very few case reports were found in literature. We conclude that a nocturnal, bilateral posterior fracture-dislocation of shoulder as a presenting feature should stimulate us to evaluate the cause, in our case it was convulsion.