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The floating shoulder.

Michael J DeFranco1, Brendan M Patterson

  • 1Department of Orthopaedic Surgery, The Cleveland Clinic Foundation, OH 44109, USA.

The Journal of the American Academy of Orthopaedic Surgeons
|August 4, 2006
PubMed
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Floating shoulder, a complex injury involving the clavicle and scapular neck, presents challenges in management due to unclear ligament disruption. Treatment decisions require careful consideration of fracture patterns and instability.

Area of Science:

  • Orthopedic Surgery
  • Traumatology
  • Anatomy

Background:

  • Floating shoulder is an uncommon but significant upper extremity injury.
  • It is often defined as ipsilateral clavicle and scapular neck fractures.
  • Ligament disruption near the scapular neck fracture can functionally mimic this pattern, even without a clavicle fracture.

Purpose of the Study:

  • To explore the complexities of floating shoulder injuries.
  • To discuss the challenges in correlating injury patterns with clinical outcomes.
  • To review current understanding and management controversies.

Main Methods:

  • Literature review of recent studies on floating shoulder injuries.
  • Analysis of diagnostic challenges, particularly assessing ligamentous injury.

Related Experiment Videos

  • Discussion of surgical and non-surgical management strategies.

    • Main Results:

    • The degree of ligament disruption is difficult to assess radiographically, complicating management decisions.
    • Minimally displaced fractures often respond well to non-surgical treatment.
    • Outcomes for non-surgically treated fractures with significant displacement or ligamentous injury are uncertain.

    Conclusions:

    • Indications for surgical versus non-surgical management of floating shoulder injuries are not well-defined.
    • Internal fixation of clavicle fractures may indirectly reduce scapular neck fractures.
    • Individualized treatment approaches based on pathoanatomy and surgeon experience are crucial due to evidence limitations.