The clinical diagnosis and treatment of the shoulder terrible tetrad: a case report and literature review

Traumatic anterior dislocation of the shoulder is often associated with anterior glenoid fracture or bankart injury. It can also be associated with rotator cuff injury, humeral greater tuberosity fracture, or brachial plexus injury. However, there are few clinical reports of all the above-mentioned injuries at the same time. We report a case of the left "Shoulder terrible tetrad." After closed reduction of the left shoulder dislocation, we performed one-stage arthroscopic massive rotator cuff repair (Chinese-Way technique) and anchor repair of the bony bankart injury. After 2 years follow-up, the left shoulder function recovered well and the range of motion was satisfactory. A detailed physical examination and electromyography (EMG) examination should be performed in time to avoid misdiagnosis and missed diagnosis, when the clinical manifestation of brachial plexus nerve injury appears after shoulder dislocation. The repairable rotator cuffs tears and bankart injuries can be repaired under shoulder arthroscopy in one stage.