PMC9045964_01
Radiographs showing bilateral proximal humeral fractures: (a) right shoulder and (b) left shoulder.
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fig1
Radiographs showed bilaterally displaced proximal humerus fractures with dislocation of the right humeral head (Figures 1(a) and 1(b)).
Computed tomography images of the right shoulder showing the four-part fracture with dislocation of the proximal humerus: (a) axial image, (b) sagittal image, (c) frontal view in a three-dimensional (3D) image, and (d) posterior view in a 3D image.
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fig2
Computed tomography revealed a fracture dislocation with displaced comminuted fracture of the greater and lesser tuberosities in the right shoulder (Figures 2(a)-2(d)) and varus displacement of the humeral head from disruption of the medial calcar support and displacement of the greater tuberosity in the left shoulder (Figures 3(a)-3(d)).
Computed tomography images of the left shoulder showing the three-part fracture of the proximal humerus: (a) axial image, (b) sagittal image, (c) frontal view in a 3D image, and (d) posterior view in a 3D image.
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fig3
Computed tomography revealed a fracture dislocation with displaced comminuted fracture of the greater and lesser tuberosities in the right shoulder (Figures 2(a)-2(d)) and varus displacement of the humeral head from disruption of the medial calcar support and displacement of the greater tuberosity in the left shoulder (Figures 3(a)-3(d)).
Postoperative radiographs after bilateral reverse shoulder arthroplasty: (a) right shoulder and (b) left shoulder.
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Cancellous chips from the humeral head were packed between the humeral shaft and the tuberosities (Figure 4(a)). Therefore, we considered a cessation of blood supply to the humeral head and decided to use an RSA for the left side using the same prosthesis as for the right side (Figure 4(b)).
Active shoulder range of motion at the most recent follow-up: (a) forward elevation, (b) abduction, (c) adducted external rotation, and (d) adducted internal rotation.
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The active range of motion was 110 degrees of flexion, 110 degrees of abduction, -10 degrees of external rotation, and L4 for internal rotation on the right side and 120 degrees of flexion, 120 degrees of abduction, -10 degrees of external rotation, and L3 for internal rotation on the left side (Figures 5(a)-5(d)).
Radiographs showing both shoulders at the most recent follow-up: (a) Grashey view and (b) transscapular Y view of the right shoulder and (c) Grashey view and (d) transscapular Y view of the left shoulder.
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Radiographs revealed no lucent line on the humerus and glenoid components, although bone resorption and superior retraction of the tuberosities on both sides were observed at the final follow-up (Figures 6(a)-6(d)).