Nerve injury following shoulder dislocation: the emergency physician's perspective

Area of Science:

• Orthopedics
• Neurology
• Emergency Medicine

Background:

• Shoulder dislocations are common orthopedic emergencies.
• Associated neurological injuries require prompt recognition and management.

Observation:

• A 57-year-old woman sustained a right anterior shoulder dislocation after a fall.
• She presented with numbness, wrist drop, and sensory loss, indicating radial nerve injury.
• Altered sensation in the ulnar distribution suggested a concomitant ulnar nerve injury.

Findings:

• Neurological deficits persisted unchanged after shoulder reduction.
• Clinical evaluation and electromyography confirmed persistent radial and ulnar nerve deficits after 3 months.
• No axillary nerve deficit was observed.

Implications:

• Shoulder dislocations carry a risk of associated peripheral nerve damage.
• Highlights the importance of thorough neurological examination in shoulder dislocation cases.
• Emphasizes the need for structured follow-up plans for patients discharged from the emergency department with neurological deficits.