Treatment of floating shoulder injury based on the stability of the superior shoulder suspensory complex.

Abstract

Objective To explore the outcome and significance of the stability of the superior shoul-der suspensory complex (SSSC) in treating floating shoulder injury (FSI). Methods Between January 1999 and September 2006, 34 patients with FSI were treated. There were 22 male and 12 female patients, with an average age of 45 (range, 24 to 67) years. The treating methods were chosen based on the stability of the SSSC and the Miller type of fracture of the scapular neck. All patients were performed clavicle fracture fixed,acromial end of clavicle fracture fixed, acromioclavicular dislocation fixed, scapular neck fracture fixed, or both at the same time. Eight cases underwent reconstruction of the coracoclavicular ligament with the use of autologous semitendinosus; 13 underwent directly suture repair of the acromioclavicular joint capsule and ligaments; 3 eases associated with acromial fractures underwent internal fixation. Results After a mean fol-low-up period of 23 months (12-72 months), according to Herscovici scoring system, the shoulder functions were excellent in 21 cases (61.8%), good in 9 (26.5%), fair in 3 (8.8%), and poor in 1 (2.9%). Active shoul-der flexion range exceeded 120° in 24 cases, 90°-120° in 8, fewer than 90° in 2 cases. After operation, five patients experienced shoulder stiffness, six shoulder pain. Conclusion The estimate of the stability of the SSSC was important to choose operation method of FSI. The restoration of the stability of the SSSC really af-fected the treatment outcome of FSI. Key words: Wounds and injuries; Acromion; Scapula; Clavicle; Shoulder fractures; Fracture fixa-tion; internal