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Forequarter amputation for open scapulothoracic dissociation: A case report and surgical technique
Arun Upreti1, Dibya Purush Dhakal1, Subarna Paudel1
1Maharajgunj Medical Campus Institute of Medicine Kathmandu Nepal.
Clinical Case Reports
|February 15, 2024
Summary
Scapulothoracic dissociation is a rare, limb-threatening upper extremity injury. This case details a severe open injury with extensive damage, ultimately requiring forequarter amputation.
Area of Science:
- Orthopedic Surgery
- Trauma Surgery
- Vascular Surgery
Background:
- Scapulothoracic dissociation is a rare injury resulting from high-energy trauma to the shoulder.
- It involves the disruption of the scapulothoracic articulation and is considered limb-threatening.
Observation:
- This report details a unique case of open scapulothoracic dissociation.
- The injury involved a laterally displaced, comminuted scapula, redundant acromioclavicular joint, total brachial plexus injury, and complete brachial artery transection.
Findings:
- The patient presented with severe, complex upper extremity trauma.
- Despite surgical intervention, vascular repair failed, necessitating forequarter amputation.
Implications:
- This case highlights the severity and devastating consequences of high-velocity shoulder trauma.
- It underscores the challenges in managing extensive injuries involving neurovascular structures and the scapulothoracic articulation.
