Anterior shoulder dislocation following postoperative limb positioning after non-shoulder orthopaedic surgery in a polytrauma patient: a case report

Background Anterior shoulder dislocation in a young polytrauma patient with no prior history of shoulder instability or injury is rare. Reports of this presentation are rare in the literature, and cases associated with postoperative limb positioning are scarcely described. Case presentation: We report a case of a 28-year-old Indian male who sustained multiple traumatic injuries including fractures of the right tibia and fibula, multiple phalanges of the right hand, and a right temporo-parietal subdural haemorrhage following a road traffic accident. The patient had no history of right shoulder injury and his right shoulder was unremarkable on initial evaluation. The patient was managed with closed reduction and internal fixation of the right tibial fracture with intramedullary nailing and K-wire fixation of the right fourth digit phalanx fractures under general anaesthesia. Postoperatively, the right upper limb was positioned in abduction and external rotation for elevation. On postoperative day two, the patient developed an anterior dislocation of his right shoulder, which was subsequently reduced using Kocher’s technique. Subsequent follow-up confirmed joint congruity to be maintained. Conclusions This case report discusses improper postoperative limb positioning as a contributing, if not causative factor of anterior shoulder dislocation in this patient. It also aims to revisit postoperative care of polytrauma patients, including appropriate positioning of limbs and monitoring to detect any untoward occurrences, as was incidentally discovered in this patient on evening rounds.