A Modified Direct Lateral Approach for Lateral Border and Scapular Spine Fixation in Floating Shoulder

Floating shoulder injuries are rare but require careful management to ensure functional recovery. Traditional approaches for scapular fixation often necessitate multiple incisions. We present a modification of the direct lateral approach that allows for scapular lateral border and scapular spine fixation using a single incision with utilization of subdeltoid space. A 48-year-old male patient presented with a displaced extra-articular scapular fracture associated with a midshaft clavicle fracture following a motor vehicle accident. The patient underwent open reduction and internal fixation (ORIF) using a standard anterior approach for the clavicle and a modified direct lateral approach for the scapula. This technique eliminated the need for a secondary incision while ensuring stable fixation and preserving deltoid origin without the need for detachment. Postoperatively, the patient demonstrated excellent range of motion without complications up till his one-year follow-up. This case highlights a less invasive yet effective technique for scapular fixation in floating shoulder injuries.