We reported on the clinical results and important points of treatment of rotator cuff tears with axillary nerve palsy caused by high energy injury. We had four cases with injured rotator cuff tears with axillary nerve palsy after anterior dislocations. They were all men(age: forty-six∼fifty-two). The first case concurred a pulmonary injury and right femur fracture. His rotator cuff was repaired three months after injury confirmed improvement of nerve palsy by electromyography. In the remaining three cases their cuff were repaired six weeks after injury, and confirmed improvement of nerve palsy. In the waiting period, ROM exercises were done against shoulder contracture. The clinical results were evaluated according to the JOA scores. The average follow up period was twenty-seven point two months. The average JOA score improved from 37.5 to 81.2 points. Axillary nerve palsy improved conservatively in all cases. All cases had a remained mild shoulder contracture but there was no instability. The early accurate diagnosis and careful treatment planning were needed. Differential diagnosis from brachial plexus injury was important Cuff tear should be repaired after confirming improvement of nerve palsy.
