Case Report: Neglected Locked Anterior Shoulder Dis- Location with Upper Brachial Plexus Injury

Authors

  • Shuja Uddin Department of Orthopedic Surgery, Lahore General Hospital, Lahore, Pakistan.
  • Ejaz Ahmad Department of Orthopedic Surgery, Lahore General Hospital, Lahore, Pakistan.
  • Husnain Khalid Department of Orthopedic Surgery, Lahore General Hospital, Lahore, Pakistan.
  • Hafiz M. Umar Department of Orthopedic Surgery, Lahore General Hospital, Lahore, Pakistan.
  • Ahmed Umair Asad Khan Department of Orthopedic Surgery, Lahore General Hospital, Lahore, Pakistan.
  • Mian M. Haneef Department of Orthopedic Surgery, Lahore General Hospital, Lahore, Pakistan.

Keywords:

Brachial plexus injury, Brachial plexus, Bankart lesion, Anterior Shoulder dislocation, Hillsach’s Lesion, MCN: Musculocutaneous nerve, OPD: Outdoor department, BPI: Brachial plexus injury, HSL: Hillsach’s Lesion, NLAD: neglected locked anterior dislocation

Abstract

Introduction: The most severe and least common side effects of shoulder dislocations are brachial plexus injury. Patients generally approach with a shoulder in abduction and external rotation, a behavior that orthopedic surgeons are accustomed to seeing in patients with an anterior type of shoulder dislocation. There are different viewpoints on whether surgery should be attempted to treat these old injuries with BPI and, if so, at what time.

Material and Method: We had a 25-year male old patient who was admitted through an outdoor clinic with a ‘neglected locked anterior dislocation’ that had been unrecognized for the last two months. After consent and fitness, he was managed with an open reduction as well as the Latarjet technique, followed by neurotization for BPI upper trunk after four months had passed with no improvement.

Result: The patient achieved 90 degrees of abduction and forward flexion in the 4th month of follow-up neurotization with a stable shoulder joint.

Conclusion: We advocate that old stuck shoulder dislocations along with BPI be reduced right after using an open method, stabilized by using the Laterjet intervention if still unstable, and surgically handle the wounded nerves after four months of no sign of regeneration.

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Published

2023-01-23

How to Cite

1.
Shuja Uddin, Ejaz Ahmad, Husnain Khalid, Hafiz M. Umar, Ahmed Umair Asad Khan, Mian M. Haneef. Case Report: Neglected Locked Anterior Shoulder Dis- Location with Upper Brachial Plexus Injury. Proceedings S.Z.M.C [Internet]. 2023Jan.23 [cited 2023Feb.1];37(1):52-5. Available from: https://proceedings-szmc.org.pk/index.php/szmc/article/view/338