A 45-year-old man attended our emergency depatrment complaining of severe both shlulders pain and numbness.He sustained a shock(220Volt,50 Hz) while working with his right hand on a switch,doing repair work at home.He stated that he felt the current going from his right hand to the left.He did not loose consciousness and did not fall.He was in contact with the switch for approximately 30 seconds.
On examination,there were only two small burn wounds at the tip of the index and middle fingers,no other wound or neurovascular deficit of his shoulder girdles and upper extremities.Range of motion of both shoulders were restricted.
Although his Myoglobin was raised at 1046 ug/L which may suggest possible myocardial infarction or muscle injury, he had no cardiac symptoms and his electrocardiogram and cardiac enzymes were normal.The Myoglobin returned to normal after a week of review.The right suprascapular neuropathy was diagnosed by electromyography.X-Ray and computed tomographic imaging showed no signs of dislocation of glenohumeral joint, but bilateral severely comminuted fractrures of the scapula,and intraartricular fracture of glenoid on the left shoulder.After magnetic resonance imaging(MRI) ,bilateral humeral head fracuture were diagnosed.
His scapular fractures were treated by open reduction and interal fixation with plate and early range of motion exercises. At 4-month follow-up, the scapulas were healed with no residual tenderness,with a Constant score 89 points of the right shoulder, 59 points of the left.