1案例资料1.1简要案情张某,男,37岁。2011年3月4日因殴打他人被公安机关羁押,羁押期间,因多次违规被人用手铐铐在房屋铁栅栏门上数日,其后张左肩部出现异常,在当地多家医院就诊,确诊为左肩胛骨脱位,张某未予积极配合治疗。此后症状逐渐加重,出现左肩部肿痛,左肩关节及左手活动明显受限,伴有左上肢麻木。经调查张某被关押前左上肢运动功能正常。1.2病历资料2012年3月张某某医院病历记载:“牵拉伤致左肩部疼痛、畸形,活动受限一年余”。入院查体:左肩部轻度肿胀,肩胛骨外翻上移畸形,左肩部锁骨中段 1 case information 1.1 brief case Zhang, male, 37 years old. On March 4, 2011, he was detained by the public security authorities for beating others. During the period of custody, he was handcuffed and handcuffed to the iron gate of the house for a few days after being beaten. Subsequently, Zhang left shoulder appeared abnormal and visited a number of local hospitals. Confirmed as left scapula dislocation, Zhang did not actively cooperate with treatment. Symptoms gradually aggravated after the emergence of left shoulder swelling and pain, left shoulder and left hand movement was significantly limited, accompanied by left upper limb numbness. After investigation, Zhang was detained before the left upper extremity motor function was normal. 1.2 medical records March 2012 Zhang Moumou hospital medical records: “pull the left shoulder pain caused by injury, deformity, limited mobility for more than a year.” Admission examination: slight left shoulder swelling, scapular uplift deformity, the middle part of the left shoulder clavicle