R ARIVANANTHAM
CHENNAI, AUG 11
When six months of neglect turned a shoulder injury into a surgical nightmare — and eight hours of precision surgery gave the arm a second chance. What began as a neglected shoulder fracture-dislocation had, over six months, evolved into a complex anatomical and neurological crisis—leaving a 52-year-old man from Jharkhand with severe loss of function in his shoulder, elbow and hand.
- 52-year-old Jharkhand man regains arm movement after rare shoulder reconstruction for neglected fracture-dislocation
- Chronic injury had created extensive scar tissue, a pseudo-joint and dangerous compression of the brachial plexus and axillary artery
- Multidisciplinary team combines Latarjet procedure, biceps tendon reconstruction and brachial plexus neurolysis to restore stability and function
- Complex eight-hour surgery brings significant pain relief and encouraging movement; patient now undergoing structured rehabilitation
- Doctors stress early treatment of shoulder injuries to prevent chronic deformity, nerve and blood-vessel damage and permanent loss of function
At SRM Prime Hospital, Chennai, a multidisciplinary surgical team undertook an exceptionally challenging reconstruction to give him back something that had become increasingly difficult to imagine: pain relief, shoulder stability and movement in his left arm.
The untreated fracture-dislocation had progressed into a chronic dislocation, with the humeral head displaced far from its normal position and trapped in dense scar tissue. A pseudo-joint had formed, while scar tissue had compressed the brachial plexus, the network of nerves controlling movement and sensation in the shoulder, arm and hand.
Adding to the surgical danger, the displaced humeral head was lying perilously close to the axillary artery, the major blood vessel supplying the arm.
The team successfully restored the shoulder to its anatomical position during an eight-hour operation, while protecting and decompressing the critical nerves and blood vessels around it.
A shoulder that had forgotten its normal anatomy
By the time the patient reached SRM Prime Hospital, the prolonged dislocation had fundamentally altered the anatomy of his shoulder.
The humeral head had moved away from its normal position and become embedded in extensive scar tissue. The joint capsule had tightened and scar tissue had accumulated around the joint, severely restricting movement.
The surgical team first repositioned the displaced humeral head and released the contracted joint capsule, removing the scar tissue that had developed around the joint.
But simply putting the shoulder back in place was not enough.
The chronic nature of the injury meant that long-term stability, nerve function and safe restoration of movement all had to be addressed during the same reconstruction.
Laterjet procedure builds a new line of defence
To improve the stability of the reconstructed shoulder, the surgeons performed a Latarjet procedure, a specialised operation in which a small piece of bone called the coracoid is transferred to the front of the shoulder socket.
The transferred bone provides additional support and helps significantly reduce the risk of the shoulder dislocating again.
The reconstruction also included biceps tendon reconstruction, along with other specialised procedures aimed at restoring the shoulder’s stability and functional anatomy.
The challenge, however, extended beyond the joint itself.
Because the prolonged dislocation had produced scar tissue around the brachial plexus, the Plastic Surgery team simultaneously performed brachial plexus neurolysis—carefully freeing the nerves from scar tissue and adhesions.
The procedure was intended to relieve nerve compression, protect neurological function and maximise the possibility of recovering strength, movement and sensation in the affected arm.
An intraoperative electrodiagnostic study of the nerves was also performed.
“One of the most challenging shoulder reconstructions”
Dr. Nikhil Jawaharlal Nahar, Consultant – Shoulder & Orthopaedic Surgeon, said:
“This was one of the most challenging shoulder reconstructions because the injury had been neglected for nearly six months. By the time the patient reached us, the shoulder had become chronically dislocated, with extensive scar tissue and compression of the brachial plexus. The displaced humeral head was also lying dangerously close to the axillary artery, the main blood vessel supplying the arm, making the surgery particularly demanding.”
He said the priority was to restore the shoulder’s normal anatomical position while protecting the nerves and blood vessels.
“This required meticulous planning, advanced imaging, intraoperative nerve monitoring and close collaboration between orthopedics, plastic surgery, anaesthesia and rehabilitation teams. After an eight-hour surgery, the patient experienced significant pain relief and regained movement in his arm, giving him the opportunity to return to his normal life and livelihood.”
The surgery was performed by a multidisciplinary team comprising Dr. Nikhil Jawaharlal Nahar, Consultant – Shoulder & Orthopaedic Surgeon; Dr. Lokesh Suryanarayanan, Consultant – Plastic Surgery; Dr. Subashini, Senior Consultant – Plastic Surgery; and Dr. K Partheeban, Clinical Lead & Senior Consultant – Anaesthesia.
The Orthopaedics team performed the complex shoulder reconstruction, including the Latarjet procedure, while Dr. Lokesh Suryanarayanan and the Plastic Surgery team freed the nerves from scar tissue and adhesions to relieve compression and preserve nerve function.
“Such cases demand not only surgical precision”
Siva, CEO, SRM Prime Hospital said:
“This case reflects the level of expertise and multidisciplinary collaboration required to manage some of the most complex orthopedic conditions. Even after six months of neglect of the fracture-dislocation, our teams were able to successfully reconstruct the shoulder using internationally accepted advanced surgical techniques, meticulous planning and seamless coordination across multiple specialties.”
He added:
“Such cases demand not only surgical precision but also careful execution to restore function while preventing further injury to critical nerves and blood vessels. At SRM Prime Hospital, we are committed to delivering world-class, evidence-based care for highly complex conditions, enabling patients to regain mobility, independence and a better quality of life.”
From surgical table to rehabilitation
Following the procedure, the patient was discharged after five days with significant pain relief and encouraging improvement in movement of his left upper arm.
He is now undergoing a structured rehabilitation programme under the guidance of the Physiotherapy and Rehabilitation team and is making steady progress towards regaining strength, mobility and functional independence.
The case also carries a strong public-health message.
Doctors have emphasised that shoulder fractures and dislocations should never be ignored, particularly when there is persistent pain, visible deformity, inability to move the arm, weakness or numbness following an injury.
Early medical evaluation and appropriate imaging after a significant shoulder injury can help prevent chronic deformity, compression of nerves and blood vessels and potentially permanent loss of function.
The lesson beyond the miracle
The success of this rare reconstruction is not merely about putting a dislocated shoulder back into place. It is about rebuilding an entire functional pathway—bone, joint, tendon and nerve—after months of damaging neglect.
For the patient, eight hours on the operating table have opened the possibility of returning to movement, independence and livelihood.
For others with serious shoulder injuries, the case carries an even more important message:
A dislocation is not an injury to “wait and watch”. Early treatment can prevent a treatable injury from becoming a surgical battle.
Patient Sanat Marandi and Dr Shrilekha Venkatesan, Assistant Director Medical Services, SRM Prime Hospital, Chennai were also present at the press conference.
