Abstract
BackgroundThe shoulder is the joint most prone to dislocating in the human body and accounts for 45% of all dislocations. In addition to ruptures of the soft tissue and bony injuries, lesions to vascular structures as well as the brachial plexus and its corresponding nerves might occur. With an incidence of up to 65%, nerve lesions are frequently reported after shoulder dislocations. The aim of this study is to obtain information on epidemiology, diagnostics, treatment and duration until remission or late sequelae after shoulder dislocation and concomitant nerve injury in a large patient cohort.MethodsThe patient cohort consisted of 15,739 patients from three centres who had sustained a shoulder dislocation. All patient files were searched for concomitant injury of the brachial plexus or its corresponding nerves. For epidemiological data analysis, demographic data, clinical follow-ups, electromyography and nerve conduction velocity were evaluated.ResultsIn total, 60 patients (32 males, 28 females) with a mean age of 60 years (range 19–88 years) met the inclusion criteria. In the majority of patients (n = 51), the trauma mechanism was a trivial fall on the outstretched arm. The most frequent dislocation direction was anterior-caudal in 61.6%, followed by strictly caudal in 16.6%. The brachial plexus was injured in 46 patients (76.6%) and isolated nerve damage was documented in 14 patients (23.3%). Electroneurographic examinations were performed in less than half of the patients (38.3%).ConclusionA combination injury of shoulder dislocation and plexus lesion may occur at any age and sometimes has a poor outcome. Electroneurographic examinations should be implemented when managing these patients as a cost-effective and supportive examination.Level of evidenceLevel IV, retrospective study.
Highlights
The shoulder is considered to be the joint with the highest mobility in the human body [9]
A total of 15,739 patients with shoulder dislocations were available for study inclusion
(16 out of 5840 Medical University of Vienna (MUVI); 10 out of 3223 AUVA Trauma Center Vienna Lorenz Böhler and 34 out of 6676 AUVA Trauma Center Vienna Meidling) with shoulder dislocations and associated plexus lesions or isolated nerve lesion were included in this study, representing an overall incidence of 0.4%
Summary
The shoulder is considered to be the joint with the highest mobility in the human body [9] This allows a wide range of motion, which might compromise stability and, Usually, the injury pattern is an external rotation and hyperextension of the arm, levering the humeral head out of the glenoid [8]. Due to the close anatomical proximity of the shoulder joint and the brachial plexus, nerve injuries are reported with an incidence of 21–65% [2,7,13]. The aim of this study is to obtain information on epidemiology, diagnostics, treatment and duration until remission or late sequelae after shoulder dislocation and concomitant nerve injury in a large patient cohort. All patient files were searched for concomitant injury of the brachial plexus or its corresponding nerves.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
