Fracture-dislocation of the shoulder and brachial plexus palsy: a terrible association

Abstract

Primary post-traumatic anterior dislocation of the shoulder with associated fracture of the greater tuberosity and brachial plexus injury is rare and, to our knowledge, has never previously been reported in the literature. We present a case of this unhappy triad in which a brachial plexus injury was diagnosed and treated 3 weeks later. The characteristics of this rare condition are discussed on the basis of our case and the published literature in order to improve early diagnosis and treatment of this lesion.

Fig. 1

a X-ray of the right shoulder revealed an antero-medial dislocation associated with a fracture of the greater tuberosity. b At a 3-week follow-up, X-ray showed the prolapse of the humeral head, which appeared inferiorly subluxated

Fig. 2

The anterior (a) and posterior (b) aspects of the shoulder 3 weeks after dislocation: marked hypotonia of the deltoid and less of the triceps muscles

Fig. 3

The diagnostic algorithm in the case of anterior post-traumatic dislocation of the shoulder and its possible complications