Painful post stroke shoulder with dislocation and grotesque contracture

This article has presented an 11-year follow-up study of a 62-year-old white female with a grotesque left upper extremity deformity following a right-sided cerebral vascular accident. The patient demonstrated a combination of four interesting complications of stroke and the treatment of its sequelae. An unusual cosmetic and functionally unacceptable fixed spastic shoulder contracture; left shoulder pain secondary to contractures and a previously undiagnosed posterior shoulder dislocation; inability to maintain proper skin hygiene of the axilla, antecubital fossa and palm because of these severe fixed contractures; failure of cryosurgery to relieve shoulder spasticity. These problems were all related to the spasticity associated with the post-stroke period. The rare and previously undiagnosed posterior shoulder dislocation was presented, and the possible etiology described. A discussion of the evaluation and treatment of these problems was presented, as well as the results of treatment in this patient.