The floating shoulder injuries
- VernacularTitle:浮肩损伤
- Author:
Jian JIA
;
Fuxing PEI
;
Luzeng GUO
- Publication Type:Journal Article
- Keywords:
Scapula;
Clavicle;
Shoulder fractures;
Fracture fixation, internal;
Treatment outcome
- From:
Chinese Journal of Orthopaedics
2001;0(05):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the clinical features and operative treatment of floating shoulder injuries. Methods The clinical data of 36 patients with floating shoulder injuries that had been admitted to our hospital from June 1999 to June 2005 were retrospectively analyzed. The scapular neck fractures associated with clavicle fractures were in 31 cases and acromioclavicular joint dislocation in 5 cases. All cases were accompanied by associated injuries, in which rib fractures combined hemopneumothorax and/or lung contusion was 88.9%. The mean time from primary injury to the fracture operation was 9.6 days (range, 3 to 43 days). The clavicle fractures or acromioclavicular joint dislocation were dealt with firstly, then scapular neck fractures treated through modified Judet posterior approach. Thirty-three cases received internal fixation with both injuries of scapular neck and clavicle or acromioclavicular joint and 3 cases received internal fixation only in clavicle shaft. Results All fractures had been restored anatomical reduction in the target site. The mean followed up time was 19.7 months (range, 6 to 69 months). According to Constant and Murley's evaluation, the median score of functional results was 93% (mean 81.3%, range from 9% to 100%). Based on Herscovici's evaluation, 25 (69.4%) cases showed excellent results, 6 (16.7) good, 4 (11.1%) fair, and 1 (2.8%) poor. The recurrence of primary hemopneumothorax was found in 1 case, shoulder joint abduction weakness and subacromial space pain in 3 cases, delayed lesion of suprascapular nerve in 1 case, and posttraumatic shoulder joint instability secondary to arthritis in 1 case postoperation. Conclusion The double injuries with scapular neck and their suspensory device of clavicular shaft or acromioclavicular joint in floating shoulder injuries can hardly be corrected and reduced in three dimensional displacement of distal fracture unit without operation. It is an effective way for such unstable injuries to get good results after open reduction and internal fixation in early stage.
