title: Chloroquine-induced bilateral anterior shoulder dislocation: a unique aetiology for a rare clinical problem.
abstract: Bilateral anterior shoulder dislocation is a rare clinical entity with few case reports and limited series published in the literature. Bilateral shoulder dislocations are rare and of them, most are posterior. We present a highly unusual case of bilateral, atraumatic, anterior shoulder dislocation with concomitant comminuted greater tuberosity fracture on the right side, secondary to seizure, in a patient without known epilepsy, induced by oral chloroquine medication. We demonstrate the treatment approach that led to a satisfactory clinical outcome, evidenced by radiological union, clinical assessment and Patient Reported Outcome Measure data, following non-operative management of both shoulders. The unusual mechanism for anterior shoulder dislocation, the asymmetric dislocation pattern and peculiar precipitant for the causative seizure all provide interesting learning points from this case.
authors.affiliation: Department of Trauma and Orthopaedics, Barnet and Chase Farm Hospital, London, UK.
authors.forename: Alexander Nicholas
authors.initials: AN
authors.lastname: Martin
authors.affiliation: Department of Trauma and Orthopaedics, Barnet and Chase Farm Hospital, London, UK.
authors.forename: Dimitris
authors.initials: D
authors.lastname: Tsekes
authors.affiliation: Department of Trauma and Orthopaedics, Barnet and Chase Farm Hospital, London, UK.
authors.forename: William James
authors.initials: WJ
authors.lastname: White
authors.affiliation: Department of Trauma and Orthopaedics, Barnet and Chase Farm Hospital, London, UK.
authors.forename: Dan
authors.initials: D
authors.lastname: Rossouw
mesh_terms: D000328:Adult; D001915:Braces; D002738:Chloroquine / Q000009:adverse effects*; D018460:Fractures, Comminuted / Q000139:chemically induced / Q000628:therapy; D006801:Humans; D008297:Male; D012640:Seizures / Q000139:chemically induced* / Q000150:complications; D012783:Shoulder Dislocation / Q000139:chemically induced / Q000000981:diagnostic imaging* / Q000628:therapy; D016896:Treatment Outcome
chemical_list: D002738:Chloroquine