Disclosures: Nick Brown: Nothing to disclose

Case Description: A 52-year-old male with a history of a severe motor vehicle collision presented with a chief complaint of persistent right shoulder weakness. Fifteen months prior he was struck as a pedestrian by a car. As a result, he sustained multiple severe facial fractures, multiple rib fractures, fractures of the left T1 and T2 transverse processes, and a comminuted transverse fracture of the right scapular body. He received multiple facial reconstruction surgeries and was kept in the hospital for over 1 month. Since then he was followed by an orthopedic surgeon and received physical therapy, but the right shoulder weakness persisted. He denied any paresthesias, weakness, or loss of range of motion in the right arm or hand. Physical exam of the right shoulder revealed marked atrophy of the infraspinatus muscle. In addition, there was a significant loss of range of active and passive motion in all planes of the right shoulder. Electromyography suggested no denervation at the biceps and deltoid muscles. He had reduced recruitment, a reduced interference pattern, and few positive sharp waves in the supraspinatus muscle, suggesting denervation. The infraspinatus muscle was difficult to measure due to significant atrophy. These findings suggested that there was injury to the suprascapular nerve with more severe denervation at the branch to the infraspinatus muscle. The suspected cause of the injury was the scapular fracture.

Setting: Outpatient clinic

Patient: A 52-year-old man with a history of a severe motor vehicle accident.

Assessment/Results: The patient was referred for physical therapy and was unwilling to consider further invasive treatment at the time. Further developments will be discussed.

Discussion: This is a unique case of persistent suprascapular neuropathy over 15 months after a scapular fracture.

Conclusion: Persistent suprascapular neuropathy is a possible sequela of a scapular fracture and should be included as a differential diagnosis of persistent shoulder weakness.

Level of Evidence: Level V

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/persistent-shoulder-pain-due-to-suprascapular-nerve-injury-in-the-setting-of-trauma-a-case-report/