Why You Should Tap Out. A Complex Shoulder Injury - Page #4
 

Working Diagnosis:
Anterior glenohumeral dislocation
Rotator cuff rupture, labrum tear
Axillary nerve palsy

Treatment:
Dislocation was reduced in Emergency Department under procedure sedation. Subsequent arthroscopy for repair of Rotator Cuff Tear and labrum. Physical therapy for nerve palsy and for surrounding muscular rehab.

Outcome:
Patient improved to the point where he had full range of motion, active and passive. He also gained back his sensation in the C5 distribution Case Photo #2

Author's Comments:
Interesting case as the patient had an impressive mechanism with significant muscular, bony, and neurologic injury,

Editor's Comments:
With the scapular function basically at zero, a locked shoulder follows the path of least resistance, the anterior escape. This is the intention of a shoulder lock in MMA fighting. Athletes are trained to "tap out" prior to injuring these structures. If they do not follow this advice, the presented injury pattern can almost inevitably be seen.

References:
MS Besson, Am J. Emer Med, 1999, vol 17, iss 3, 288-295
Perlmutter, Am J sports med, 1997, vol 25, no 1, 65-68
Travlos J of Bone and Joint Surg, vol 72-B, issue 1, 68-71

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