Delayed Appearance of Neuropathy After Inferior Shoulder Dislocation

Complications regarding inferior shoulder dislocations (ISD) are predominately rotator cuff injuries, neuropathies, and vascular insults. To our knowledge, there are no studies regarding the delayed appearance of neuropathies with inferior shoulder dislocations. A 32-year-old previously healthy male presented with an inferior shoulder dislocation that required open reduction and internal fixation after failed attempts at closed reductions in the emergency room and operating room. At the time of discharge, the patient had no neurologic complaints, which continued to the two-week follow-up appointment. The patient did not complain of numbness or tingling until the six-week follow-up visit, at which point electromyography revealed a severe axillary nerve neuropathy. Neuropathic complications following inferior shoulder dislocations to date have been detailed and described immediately after injury, with some resolving after reduction. The generally accepted theory regarding the pathophysiology of neuronal injury after trauma, Wallerian degeneration, does not account for the six-week delay in neuropathy demonstrated in this case report. This illustrates the importance of specifying the onset of neuropathies after inferior shoulder dislocation, which may lead to a more comprehensive theory regarding the pathophysiology of delayed presentations of neuropathy after inferior shoulder dislocation.