{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T16:15:10Z","timestamp":1761581710537,"version":"3.44.0"},"reference-count":15,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2018,5,23]]},"abstract":"<jats:p>A \u2018terrible triad\u2019 of anterior shoulder dislocation, axillary nerve damage and rotator cuff tear has been previously described. However, we are unaware of any report of anterior shoulder dislocation, humeral fracture, axillary neuropathy and subsequent rotator cuff tear requiring surgery when the axillary neuropathy was deemed permanent. We report the case of a 20-year-old woman who fell in a motocross accident and had an anterior shoulder dislocation, humeral fracture and axillary neuropathy. The fracture was treated surgically with open reduction and internal fixation. The axillary nerve injury was ultimately permanent. Thirteen months after the motocross accident, the patient sustained a rotator cuff tear from seemingly minor trauma. However, several months of aggressive physical therapy preceded the rotator cuff tear. The tear was repaired and the patient was followed for 5\u2009years after the initial injury. She returned to competing in motocross, even though the axillary neuropathy remained complete and permanent.<\/jats:p>","DOI":"10.1136\/bcr-2017-223692","type":"journal-article","created":{"date-parts":[[2018,6,16]],"date-time":"2018-06-16T01:54:55Z","timestamp":1529114095000},"page":"bcr-2017-223692","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Rotator cuff tear following long-standing axillary neuropathy in a female motocross racer"],"prefix":"10.1136","volume":"2018","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2352-980X","authenticated-orcid":false,"given":"John G","family":"Skedros","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, The University of Utah, Salt Lake City, Utah, USA"},{"name":"Orthopaedic Surgery, Intermountain Medical Center, Murray, Utah, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tanner R","family":"Henrie","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, The University of Utah, Salt Lake City, Utah, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitchell D","family":"Peterson","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, The University of Utah, Salt Lake City, Utah, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,6,15]]},"reference":[{"key":"2025082805244178000_2018.jun14_2.bcr-2017-223692.1","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1016\/j.emc.2010.06.006","article-title":"Emergent evaluation of injuries to the shoulder, clavicle, and humerus","volume":"28","author":"Malik","year":"2010","journal-title":"Emerg Med Clin North Am"},{"key":"2025082805244178000_2018.jun14_2.bcr-2017-223692.2","doi-asserted-by":"publisher","DOI":"10.1067\/mse.2001.118002"},{"issue":"Suppl","key":"2025082805244178000_2018.jun14_2.bcr-2017-223692.3","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/0303-8467(93)90030-K","article-title":"Mechanisms of brachial plexus lesions","volume":"95 Suppl","author":"Coene","year":"1993","journal-title":"Clin Neurol Neurosurg"},{"key":"2025082805244178000_2018.jun14_2.bcr-2017-223692.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0303-8467(99)00011-6"},{"key":"2025082805244178000_2018.jun14_2.bcr-2017-223692.5","doi-asserted-by":"publisher","DOI":"10.1097\/00005131-199410000-00010"},{"key":"2025082805244178000_2018.jun14_2.bcr-2017-223692.6","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/S1058-2746(10)80008-4","article-title":"The terrible triad: anterior dislocation of the shoulder associated with rupture of the rotator cuff and injury to the brachial plexus","volume":"4","author":"Groh","year":"1995","journal-title":"J Shoulder Elbow Surg"},{"key":"2025082805244178000_2018.jun14_2.bcr-2017-223692.7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/00131402-200209000-00001","article-title":"Peripheral nerve injury associated with shoulder trauma: a retrospective study and review of the literature","volume":"4","author":"Payne","year":"2002","journal-title":"J Clin Neuromuscul Dis"},{"key":"2025082805244178000_2018.jun14_2.bcr-2017-223692.8","first-page":"1","article-title":"Concurrent rotator cuff tear and axillary nerve palsy associated with anterior dislocation of the shoulder and large glenoid rim fracture: a \u201cterrible tetrad\u201d","volume":"2014","author":"Takase","year":"2014","journal-title":"Case Rep Orthop"},{"key":"2025082805244178000_2018.jun14_2.bcr-2017-223692.9","doi-asserted-by":"crossref","first-page":"1361","DOI":"10.1007\/s00256-013-1667-7","article-title":"The deltoid, a forgotten muscle of the shoulder","volume":"42","author":"Moser","year":"2013","journal-title":"Skeletal Radiol"},{"key":"2025082805244178000_2018.jun14_2.bcr-2017-223692.10","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.2106\/00004623-197052060-00001","article-title":"Displaced proximal humeral fractures. 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