Surgical treatment of floating shoulder injury

Abstract

Objective To explore method and outcomes of surgical treatment for floating shoulder injuries(FSI).Methods Twenty-four patients with FSI were treated from January 2001 tO December 2007.According to HUANG Chang-ming's classification,these cases were classified into three FSI types:14 cases of type A(ipsihteral fractures of the scapular neck and clavicle shaft),6 cases of type B(ipsilateral fractures of the scapular neck and distal part of the clavicle),and 4 cases of type C(ipsilateral fractures of the scapular neck and acromioclavicular joint dislocation).All of them were surgically treated.Fixation of the clavicle or acromioclavicular joint was carried out in 7 cases.Fixation of the clavicle or acromioclavicular joint combined with scapular neck fixation was done in 17 cases.The ghnopelar angle(GPA)was measured preoperatively and postoperatively in all cases.Results Preoperatively there were:5 cases with GPA≥30°,8 cases with GPA 20°～29°,11 cases with GPA＜20°.Postoperatively 19 cases had GPA≥30°,while 5 cases had GPA 20°～29°.GPA of the affected shoulders was significantly improved after the surgery(P＜0.05).All patients were followed up for 3 months to 4 years(average 16 months).The mean fracture healing time was 15 weeks(range 11 to 27 weeks).According to Hardegger functional evaluation system the results were grades as excellent in 13 cases,good in 9 cases and fair in 2 cases.Conclusion Floating shoulder injury is the severe disruption of superior suspensory shoulder complex.surgical treatment with open reduction and internal fixation is the basic for early rehabilitation which is critical to the recover of shoulder functions. Key words: Shoulder fractures; surgical procedures,operative; Fracture fixation,internal