Revisiting Pre-Transplant Testicular Radiation for Relapse Prophylaxis in Allogeneic Hematopoietic Cell Transplantation (HCT) for Acute Lymphoblastic Leukemia (ALL)

Injury to the anteroinferior labrum (Bankart lesion) and capsuloligamentous complex is the most common injury pattern in young patients following a traumatic anterior shoulder dislocation. Concomitant injuries including glenoid rim (Bony Bankart) and humeral head compression fractures (Hill-Sachs lesion) have been reported to occur in up to 34 and 90% of first-time dislocations, respectively.12 Pectoralis major tendon rupture is a relatively uncommon injury that is not typically associated with events of acute shoulder instability. In over 25 years, only a single case of pectoralis major tendon rupture with simultaneous anterior shoulder dislocation has been reported in the literature.2We present the second reported case of a traumatic anterior shoulder dislocation resulting in a complex anteroinferior labral tear and concomitant pectoralis major tendon rupture in a healthy 28-year-old male following an altercation. Surgical management and the authors’ preferred technique is described.Pectoralis major tendon rupture is a possible accompanying injury in traumatic anterior shoulder dislocations in a younger patient. Physical examination and advanced imaging assessment should evaluate for this uncommon associated injury, which has the potential to influence treatment decisions and discussion between the patient and provider.