Drop Hand as A Rare Complication of Anterior Glenohumeral Dislocation: A Case Report of Radial Nerve Palsy

Background: Anterior shoulder dislocation is the most common type of glenohumeral dislocation, often associated with soft tissue injury, one of them is neurologic deficit. Objectives: Radial nerve palsy following glenohumeral dislocation without associated fracture is a rare complication that can lead to significant functional impairment, such as drop hand that characterized by the inability to extend the wrist and fingers. Glenohumeral dislocation with drop hand will severely impair hand function and the ability to perform activities of daily living. Aim: To assess the effectiveness of rehabilitation program in improving ROM, muscle strength and recovery of radial nerve function in a patient following a shoulder dislocation. Methods: This case report discusses a 36-year-old female patient who developed radial nerve palsy after an anterior dislocation of the right glenohumeral joint due to a motorcycle accident. The patient presented with shoulder pain, inability to extension the wrist and fingers, and occasional tingling sensation in the dorsal right hand. Initial radiographs confirmed anterior dislocation of the right glenohumeral joint without associated fracture and the patient underwent open reduction and internal fixation (ORIF) with pinning. Postoperatively, wrist and thumb extension remained impaired, and rehabilitation program was initiated including ultrasound diathermy, gradual range of motion exercise and muscle strengthening for right shoulder, electrical stimulation, stretching and passive range of motion on extensor group of wrist and finger muscles and give wrist splint. Result: The results of the serial examinations over a four month period showed gradual improvement in ROM and MMT grade. Conclusion: Postoperative medical rehabilitation therapy plays a crucial role in enhancing muscle strength and promoting recovery in patients radial nerve palsy with shoulder dislocation and still need to continue until full recovery.