A case report: Simultaneous bilateral posterior shoulder and unilateral central acetabular fracture dislocations secondary to epileptic seizure

Shih-Wen Kao ； Hung-Kai Lo ； I-Chang Chang ； Chih-Lung Wu

《Formosan Journal of Musculoskeletal Disorders》 9卷3期 (2018/08) Pp. 125-129

https://doi.org/10.6492/FJMD.201808_9(3).0008

摘要

Fracture dislocations of extremities are a possible complication following epileptic seizures. Management mainly depends on the severity of the injury and the current medical status of the patient. We describe a rare case of bilateral posterior shoulder and unilateral central acetabular fracture dislocations without direct trauma after a convulsive seizure related to lung cancer with brain metastases. Two weeks after the seizure, we performed an open reduction and internal fixation (ORIF) with locking plate to treat bilateral posterior shoulder fracture dislocations when the patient’s neurological condition became more stable. However, nonoperative treatment was selected for the acetabular fracture dislocation because of the patient’s advanced-stage cancer. Since the patient was responding well to the newest target therapy for his lung cancer, and his life span is beyond our estimate, we, therefore, performed a total hip replacement 6 months later because of traumatic osteoarthritis development. The clinical outcome was satisfactory at the 6-month follow-up. Due to medical progress in non-small cell lung cancer treatment, we consider aggressive treatment may be necessary even in such advanced stage patients.

關鍵字

central acetabular fracture dislocation ； lung cancer ； posterior shoulder fracture dislocation ； seizure