Acute massive rotator cuff tear and biceps tendon dislocation following posterior shoulder dislocation: A case report

Posterior shoulder dislocation is a rare injury. It accounts for only 1%-4% of all shoulder dislocation cases. However, this injury is often underdiagnosed. Massive rotator cuff tears associated with posterior shoulder dislocation are exceptionally rare. Early diagnosis and surgical management are crucial for restoring shoulder function and preventing long-term disability.

A 60-year-old male with no previous shoulder injuries presented to our hospital with severe right shoulder pain and immobility after a motorcycle accident. He reported that he braced his fall with his right hand. Initial imaging examination revealed posterior shoulder dislocation with minimal glenoid bone loss. Six days after the injury, the patient exhibited pseudoparalysis and active forward flexion limited to 10°. Two weeks after the injury, magnetic resonance imaging revealed complete tears of the supraspinatus, infraspinatus, and subscapularis muscles as well as dislocation of the long head of the biceps tendon. Arthroscopic rotator cuff repair was performed 6 weeks after injury. The tendon quality was acceptable with minimal fatty infiltration. At the 12-month surgical follow-up, the patient had recovered full strength and complete range of motion.

Early diagnosis and tailored repair of massive rotator cuff tears after dislocation are crucial for restoring shoulder function in older patients.