Quadruple superior shoulder suspensory complex injury with bony Bankart lesion: a case report

We present a 37-year-old male with a quadruple injury of the superior shoulder suspensory complex (SSSC), comprising acromial fracture, coracoid process fracture, acromioclavicular joint dislocation, and bony Bankart lesion, following a 3-meter fall. Multimodal imaging (X-ray, 3D-CT, MRI) enabled precise diagnosis. A sequential surgical strategy—open reduction and internal fixation for bony ring reconstruction followed by arthroscopic Bankart repair—was performed under an Enhanced Recovery After Surgery (ERAS) protocol. At 6-month follow-up, the Constant-Murley score improved from 28 to 86, VAS pain score dropped from 8 to 1, and shoulder range of motion improved significantly. This case demonstrates that an integrated approach combining biomechanical reconstruction, minimally invasive intra-articular repair, and multidisciplinary perioperative care can achieve excellent functional outcomes in complex SSSC injuries.