Scapulothoracic Dissociation and Clavicle Fracture with Associated Brachial Plexus Palsy

Scapulothoracic dissociation is the traumatic separation of the scapula from the thoracic wall. It is the outcome of rare, high-energy trauma to the shoulder girdle and may include vascular and neurologic damage of the upper extremity. Of the few cases presented in the literature, the majority refer to polytrauma patients. We present a rare variant of scapulothoracic dissociation combined with comminuted fractures of both the scapula and the clavicle associated with brachial plexus palsy. There were also vertebral fractures of the spinous processes of C6, T4, T5, and T6, of the transverse processes of T1 and T2, and of the anterior and middle column of T12. An open reduction and internal fixation of the clavicle was performed, and the patient was hospitalized in the intensive care unit and on the ward. The patient had a good recovery, involving extensive physiotherapy during hospitalization and after discharge to a rehabilitation center. Scapulothoracic dissociation can have potentially disastrous implications. The diagnosis is sometimes challenging because it usually involves polytrauma patients who have multiple life-threatening injuries. The diagnosis and management of this injury is of significant importance, and immediate surgical intervention should be performed when required.