Abstract
We report a case of a complex shoulder injury not previously described which presented unique challenges in its management.A motorcyclist sustained an injury to his right shoulder consisting of a Rockwood type 5 dislocation of the acromioclavicular joint, fracture of the coracoid process and a displaced comminuted fracture of surgical neck of humerus extending into the proximal diaphysis.The humeral fracture was directly reduced and stabilised with a contoured AO buttress plate. The acromioclavicular joint was reduced and held by two percutaneous 4mm threaded pins. The shoulder was immobilised in a poly-sling.Post-operatively there was a restricted exercise program involving pendular movements only. The acromioclavicular joint threaded pins were removed at 8 weeks following which further mobilisation was encouraged. He made satisfactory progress with complete radiographic fracture healing by 4 months.The management of each of these injuries in isolation has been well described, however when managed together there are unique challenges.This is unique and severe complex shoulder injury never previously reported. The method of management described, treating the injuries promptly using simple techniques, resulted in a good functional recovery.
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