Skedros John G, Henrie Tanner R, Peterson Mitchell D
Department of Orthopaedic Surgery, The University of Utah, Salt Lake City, Utah, USA.
Orthopaedic Surgery, Intermountain Medical Center, Murray, Utah, USA.
BMJ Case Rep. 2018 Jun 15;2018:bcr-2017-223692. doi: 10.1136/bcr-2017-223692.
A 'terrible triad' of anterior shoulder dislocation, axillary nerve damage and rotator cuff tear has been previously described. However, we are unaware of any report of anterior shoulder dislocation, humeral fracture, axillary neuropathy and subsequent rotator cuff tear requiring surgery when the axillary neuropathy was deemed permanent. We report the case of a 20-year-old woman who fell in a motocross accident and had an anterior shoulder dislocation, humeral fracture and axillary neuropathy. The fracture was treated surgically with open reduction and internal fixation. The axillary nerve injury was ultimately permanent. Thirteen months after the motocross accident, the patient sustained a rotator cuff tear from seemingly minor trauma. However, several months of aggressive physical therapy preceded the rotator cuff tear. The tear was repaired and the patient was followed for 5 years after the initial injury. She returned to competing in motocross, even though the axillary neuropathy remained complete and permanent.
先前曾描述过肩前脱位、腋神经损伤和肩袖撕裂的“可怕三联征”。然而，我们尚未知晓有任何关于肩前脱位、肱骨骨折、腋神经病变以及在腋神经病变被认为是永久性的情况下随后需要手术治疗的肩袖撕裂的报告。我们报告了一名20岁女性的病例，她在一场摩托车越野事故中摔倒，出现了肩前脱位、肱骨骨折和腋神经病变。骨折通过切开复位内固定术进行了手术治疗。腋神经损伤最终成为永久性损伤。在摩托车越野事故发生13个月后，患者因看似轻微的创伤导致了肩袖撕裂。然而，在肩袖撕裂之前进行了数月积极的物理治疗。撕裂处进行了修复，患者在初次受伤后接受了5年的随访。尽管腋神经病变仍然完全且永久存在，但她恢复了参加摩托车越野比赛。
