• Junwei Wu, Lianxin Li, Fengrui Wang, Shun Lu, Fanxiao Liu, Honglei Jia, Yongliang Yang, Fu Wang, Zhenhai Hao, Shihong Xu, and Bomin Wang.
• Department of Orthopaedics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324 JingWu Road, 250021, Jinan, Shandong, PR China.
• Medicine (Baltimore). 2020 Sep 4; 99 (36): e22088.

RationaleBilateral posterior fracture-dislocation of the shoulders occurs rarely and the diagnosis is often challenging. This injury is often missed or delayed on initial presentation, leading to continuous pain, disability, and rising medical costs. Timely diagnosis and proper treatment are very important to restore shoulder function.Patient ConcernsHere we report 2 rare cases. Case 1 was a 53-year-old physical worker with severe pain and limited shoulder movement after an unexpected fall. Case 2 was a 55-year-old man with pain in upper limbs and shoulders after an electric shock.DiagnosisBoth of them were diagnosed as bilateral posterior fracture-dislocation of the shoulders by computed tomography (CT) scan.InterventionAfter systematic preoperative evaluation, both of them were treated with open reduction and internal fixation.OutcomesAfter 16 months follow-up, case 1 was pain-free in both shoulders. He had returned to full activity and was satisfied with his level of function. At 24 months follow-up, both shoulders of case 2 were painless and stable with acceptable range of motion and he was able to carry out daily activities.LessonsOur case reports highlight that bilateral posterior fracture-dislocation of the shoulders is easy to be missed; one way to prevent missing diagnosis is to suspect cases with pain and limited external rotation, especially those with a history of seizures, electric shock, or severe trauma; appropriate history inquiry, physical examination, proper shoulder images are the key to correct diagnosis.

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