Purpose of the study: Accidents caused by power-take-off shafts produce different types of injuries. The lesions can vary from simple skin abrasion to amputation or serious, sometimes fatal, limb damage. We present a series of injuries treated in our institution since 1997 in order to analyze the circumstances of these accidents and their pathophysiological mechanisms as well as the most appropriate treatment. We also analyzed the mechanism of the power-take-off shaft with a few fundamental aspects to better understand the potential health hazard.

Material and methods: Ten victims of power-take-off accidents were treated in our institution since 1997. All were men aged 26 to 66 years. In all cases but one, a cord caught on the turning shaft was the cause of the accident. Eight of the patients presented upper limb injuries of variable gravity.

Results: Outcome after treatment depended on several factors: the severity of the injury, the circumstances of the accident and the proximity to a health care center. In general, the sequelae were worse for serious injuries, producing permanent disability.

Discussion: The power-take-off transmits power from the tractor to agriculture machines via a turning shaft. Correct use requires several safety measures. Serious injury, disability or death can result from inadequate protective measures or inadequate knowledge about proper use.

Purpose of the study: The purpose of this presentation was to focus on the situation where rotator cuff tears are associated with nerve injury and to clarify the clinical nosology of the shoulder triad (glenohumeral dislocation, acute cuff tear, and circumflex nerve injury) and of the «dead shoulder syndrome» (chronic massive cuff tear, acute glenohumeral dislocation, and circumflex nerve injury).

Material and methods: This series included seven patients with the shoulder triad and five patients with dead shoulder syndrome who were treated in our department between 1996 and 2002. There were nine men and three women, aged 50–74 years (mean 58 years). Follow-up was two years or more. The Neer and Cofield classification was used to assess functional outcome and the simple shoulder test (SST) was recorded.

Results: For the patients with the shoulder triad, outcome was excellent to satisfactory in all, with frontal and vertical elevation greater than 90°, nearly normal rotations, and acceptable force and range of motion for daily, occupational and sports activities. The patients with dead shoulder syndrome were a more heterogeneous population. Clinical outcome was less satisfactory although there was a real improvement in range of motion. Occasional pain was reported and some of the patients were satisfied.

Conclusion: Combined lesions of the shoulder create a difficult diagnostic and therapeutic situation. As when occurring alone, it is important to recognize injury early in order to adapt treatment to achieve functional improvement.