A 30 year old male from mallavalli taluk, Mysore presented with severe deformity and unable to move his both upper limbs since 20 days after fall from height. He was sitting over cement well when he had a sudden onset of generalised seizure. He lost consciousness and fell on the ground. There was no external wound and associated injury in other parts of the body. He was taken to a local osteopath and massaging was done. He was later brought to our center 20 days after injury. On presentation he complained of severe bilateral shoulder pain with difficulty in movements of both the shoulders. Physical examination findings included bilateral flattening of shoulder, restricted and painful movements in all ranges of shoulder joint []. Distal neuro vascular status of both upper limbs was normal. Radiological investigation revealed comminuted fracture neck of right humerus (Neer’s 4 part fracture []) and greater tuberosity of left humerus (Neer’s 2 part fracture) with bilateral subcoracoid dislocation of shoulder []. Closed manipulations under general anaesthesia was unsuccessful in reducing the dislocations (as expected in delayed presentations). Open reduction and internal fixation on both the sides was planned. Deltopectoral approach was taken bilaterally. Joint capsule was divided and fracture site directly visualized. On left side the joint was relocated and the tuberosity fracture was repositioned. K wires were passed securing the tuberosity fracture and were advanced further to transfix the glenohumeral joint, maintaining reduction. On right side, reconstruction of proximal humerus fracture was done using simple plate and screws. The reconstructed proximal humerus was then relocated into the glenoid cavity and transfixed with K wires. Primary rotator cuff repair was done on both the sides. Deltoid muscle was repaired in single layer. Wound was closed in layers. Bilateral U slab immobilization was done []. The shoulders were kept immobilized for 3 weeks at the end of which K wires were removed and shoulder rehabilitation was started. At one year follow up the patient had acceptable range and was able to carry out daily activities. Radiographs showed good union ()