Bilateral posterior shoulder fracture-dislocation following low-energy trauma treated with 3D-printed surgical planning: A case report and literature review

Bilateral posterior shoulder fracture–dislocation is rare and frequently missed, particularly after low-energy trauma. Delayed diagnosis can lead to worse outcomes and more invasive treatment. A 60-year-old previously healthy man presented after a ground-level fall with bilateral shoulder pain, restricted motion, and inability to externally rotate. Initial anteroposterior radiographs raised suspicion for posterior dislocation; computed tomography confirmed bilateral posterior glenohumeral dislocation with comminuted proximal humeral fractures and reverse Hill–Sachs lesions. Three-dimensional (3D) reconstructions and patient-specific 3D-printed models were used to better delineate fracture morphology, rehearse reduction strategies, and support joint-preserving open reduction and internal fixation rather than arthroplasty. Total combined operative time for both shoulders was 182 minutes. At 12-month follow-up, the patient was pain-free with symmetric forward elevation of 130°, and Constant–Murley scores were 78 (right) and 81 (left), without early complications. This case highlights the diagnostic challenge of bilateral posterior shoulder fracture–dislocation after low-energy trauma. Advanced imaging and patient-specific anatomical modeling may serve as useful adjuncts to support diagnosis and surgical planning in selected complex cases. This approach warrants further investigation in larger studies.