BILATERAL ROTATOR CUFF TEARS DUE TO TETANUS: A CASE REPORT

Abstract Objectives To report a rare case of bilateral rotator cuff tears caused by generalized tetanus, analyze the injury mechanism, and describe surgical treatment, rehabilitation, and one-year follow-up. Methods The 53-year-old male patient, presenting with bilateral shoulder pain and restricted mobility and a history of tetanus 5 months prior, underwent magnetic resonance imaging (MRI) which confirmed bilateral rotator cuff tears. Following three months of physical therapy and medical management that failed to alleviate symptoms or improve shoulder function, surgical intervention was performed: the right rotator cuff tear was repaired via a mini-open surgical approach, while the left tear was managed conservatively. Postoperatively, the patient received standardized rehabilitation protocols and regular follow-up assessments. Results Conservative management of the left shoulder resulted in pain relief and satisfactory functional recovery. The surgical incision achieved primary healing. The patient had no procedure-related complications after surgery. The patient demonstrated significant recovery of shoulder joint function, with marked improvements in muscle strength and sensory function compared to the pre-treatment baseline. At the last follow-up, the operated right shoulder demonstrated a Constant Score of 79, Neer Shoulder Score of 70, University of California, Los Angeles (UCLA) Shoulder Rating Scale of 26, and American Shoulder and Elbow Surgeons (ASES) Score of 59.5. Conclusions Generalized tetanus can lead to rotator cuff tears, which present diagnostic challenges with a high propensity for underdiagnosis and misdiagnosis, warranting increased clinical vigilance. The open rotator cuff repair is an optional surgical procedure for treating rotator cuff tears caused by generalized tetanus. Acknowledgments This research was supported by the Natural Science Foundation of Shandong Province (No. ZR2022MH056, No. ZR2021QH307).