Treatment of a Combined Pectoralis Major Tear, Anterior Labral Tear, and Humeral Avulsion of the Glenohumeral Ligament (HAGL) in an Active Duty Soldier

ABSTRACT Anterior glenohumeral instability is an increasingly common injury among young military servicemen. First-time dislocations occurring in combination with anterior labral tears and humeral avulsion of glenohumeral ligament lesions, although rare, significantly contribute to further shoulder dysfunction with recurrent instability and pain. Tears of the pectoralis major are also a type of injury more common in the military population, with operative management resulting in decreased strength. We present a unique case of a young, active duty male that sustains an anterior shoulder dislocation with a concomitant pectoralis major tendon rupture while bench press weight lifting in preparation for the Army Special Forces selection. To the best of our knowledge, this is the first case presented in the literature describing management of a simultaneous anterior shoulder dislocation, humeral avulsion of glenohumeral ligament lesion, and pectoralis major tendon rupture treated with a single operation. After aggressive rehabilitation, the patient was able to successfully pass Special Forces selection and has near full function of the operative shoulder with remarkable satisfaction scores.

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Compartment Syndrome of the Flexor Compartment of the Arm Secondary to Pectoralis Major Tendon Rupture

Case Reports in Orthopedics ◽

10.1155/2018/9042820 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5

Author(s):

M. A. Tranovich ◽

J. B. Stirton ◽

J. C. Maier ◽

M. B. Tanios ◽

J. E. Lea ◽

...

Keyword(s):

Compartment Syndrome ◽

Tendon Rupture ◽

Pectoralis Major ◽

Weight Lifting ◽

Rare Entity ◽

Anterior Compartment ◽

Muscle Rupture ◽

Missed Compartment Syndrome ◽

High Level

Case. Compartment syndrome following muscle rupture is a rare entity with few mentions in the literature. We present a case of pectoralis major rupture in a 38-year-old male that evolved into compartment syndrome of the anterior compartment of the arm. Rupture of the pectoralis is uncommon and most often occurs during weight lifting. Compartment syndrome secondary to this injury is extremely uncommon, with only one reported case in the pectoralis major itself and several cases of biceps compartment syndrome. Due to the potentially devastating consequences of a missed compartment syndrome, it is imperative that physicians maintain a high level of suspicion in patients with these unusual injuries presenting with severe swelling and pain.

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Intra-articular Lesions and Clinical Outcomes in Traumatic Anterior Shoulder Dislocation Associated with Greater Tuberosity Fracture of the Humerus

Clinics in Shoulder and Elbow ◽

10.5397/cise.2017.20.4.195 ◽

2017 ◽

Vol 20 (4) ◽

pp. 195-200 ◽

Cited By ~ 1

Author(s):

Kuk Pil Lim ◽

In Seung Lee ◽

In Bo Kim

Keyword(s):

Clinical Outcomes ◽

Shoulder Dislocation ◽

Anterior Shoulder Dislocation ◽

Simple Shoulder Test ◽

Greater Tuberosity ◽

Glenohumeral Ligament ◽

Orthopedic Surgeons ◽

Traumatic Anterior Shoulder Dislocation ◽

The Mean

BACKGROUND: This study investigated and evaluated the clinical outcomes of intra-articular lesions of traumatic anterior shoulder dislocation (TASD) associated with greater tuberosity (GT) fracture of the humerus.METHODS: Subjects included 20 patients who were surgically or non-surgically treated for GT fracture of the humeurs with TASD, and followed-up for at least 2 years. The mean follow-up period was 54.1 months (range, 24?105 months). Of the 20 patients, 12 were treated surgically. Intra-articular lesions were identified randomly on magnetic resonance imaging scans (repeated thrice) by experienced radiologists and orthopedic surgeons. The accompanying intra-articular lesions were left untreated. Clinical outcomes were evaluated by Simple Shoulder Test (SST) and Western Ontario Shoulder Instability index (WOSI) at the last follow-up.RESULTS: Intra-articular lesions were identified in 19 patients: 7 Bankart lesions, 15 humeral avulsion of the glenohumeral ligament lesions, 3 glenoid avulsion of the glenohumeral ligament lesion, and 6 inferior capsular tears. Two or more intra-articular lesions were identified in 6 patients. The mean SST score was 10.9 and the mean WOSI score was 449.3 at the last follow-up.CONCLUSIONS: For GT fracture of the humerus with TASD, a high frequency of diverse intra-articular lesions was identified. There were no incidence of recurrent shoulder dislocations, and good clinical outcomes were obtained without treatment of the intra-articular lesions. We thereby comprehend that although intra-articular lesions may occur in TASD associated with GT fracture of the humeurs, merely treating the GT fracture of the humerus is sufficient.

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