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03/02/2022

UCA Clinical Case: Floating shoulder after MTB accident

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We explore the clinical case of a 55-year-old male who suffered an accidental Mountain Bike fall that resulted in a fracture of the scapula, displaced glenoid and left clavicle.

FLOATING SHOULDER

Floating shoulder, an injury in which the stability of the suspensory complex of the shoulder is lost. It is defined as two or more injuries to the bone or ligament components of the shoulder. This pathology is an infrequent condition mostly related to high energy mechanisms.

 CAT scan

The CAT shows a complex fracture of the scapula with an outline of the body extending to the body and to the marginal part of the glenoid. The stroke of the neck is oblique from inferior to superior, from the upper lateral scapular margin to the medial border, thus affecting the scapula spine.

La afectación glenoides afecta a la glenoides inferior, es intraarticular, con un trazo completo. El fragmento glenoideo posterior e inferior esta desplazado de forma inferior, mide 18x24mm.

A partir del T.A.C. se elaboró la pieza volumétrica en 3D

SURGICAL TREATMENT

First stage: clavicle fracture and osteosynthesis of the clavicle 

Second stage: glenoid fracture

Posterior approach to the lateral scapular pillar between infraspinatus and teres minor. 

The comminuted scapular fracture with inferior glenoid stroke is pointed out. 

Reduction and osteosynthesis are carried out with a lateral pillar anatomical neutralisation plate.

POSTOPERATIVE PERIOD