Management of floating shoulder injury with dual surgical approach
Journal Title: International Journal of Orthopaedics Sciences - Year 2017, Vol 3, Issue 1
Abstract
Background: The floating shoulder is an uncommon but important injury pattern. Although it is frequently defined as an ipsilateral fracture of the clavicle and scapular neck, studies suggest that ligament disruption associated with a scapular neck fracture contributes to the functional equivalent of this injury pattern, with or without an associated clavicle fracture. Minimally displaced fractures typically do well with nonsurgical care. However, the degree of fracture displacement and ligament disruption that results in less predictable outcomes after nonsurgical treatment is uncertain. Internal fixation of a displaced clavicle fracture restores the contour of the shoulder, regulates soft-tissue tension, but it does not reduces the scapular neck fracture. Hence fixation of both fractures is recommended in certain fracture patterns. Material & Methods: This is a study of 10 cases of floating shoulder injury operated by front (ant. Approach for # clavicle) and back (modified Judets posterior approach for scapula #) from Jan 2012 to March 2016. All cases were assessed with Constant shoulder score at the end of six months. Results: Results of our study shows that majority of pt. had excellent to good results. There were complications in two cases; 1.Broken Clavicle plate which needed revision, 2.Failure to anatomically reduce scapula neck fracture and proximal screw penetration in to the joint. Conclusion: We propose the combined anterior and posterior surgical approach to be the method of choice for the treatment of unstable and displaced floating shoulder injuries.
Authors and Affiliations
Dr. Anand Gupta, Dr. Ashok Nagla, Dr. Pradeep Chaudhery
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