European Journal of Molecular & Clinical Medicine

Abstract

Aim: to determine the functional outcome of surgical fixation in significantly displaced floating shoulder       injury.
Materials and Methods: This retrospective observational study was carried out in the Department of Orthopaedics, Sri Krishna Medical College and Hospital, Muzaffarpur, Bihar, India, for 15 months. 20 significantly displaced floating shoulders (scapular neck medialization >10mm and GPA <30^◦) were selected. The minimally displaced floating shoulder, intrarticular fractures of shoulder joint and the patients having any associated life threatening injury were excluded. Standard X-ray shoulder AP and Lateral views both pre and post operative were obtained. Pre operative CT scan with 3D reconstruction was obtained in most of the cases. Clavicular fracture and scapular fracture were classified according to Allman and Goss classification respectively. The clinico- radiological assesment was done at every subsequent 4 weeks of interval with X-ray shoulder AP/Lateral view and Oxford Shoulder Score till 9 months.
Results: Out of 20,15 had sustained injury due to motor vehicle accident while 5 had history of fall from height. There were 14 males and 6 females. Mean age was 37.4 years. The mean delay in surgery from the day of accident was 6.1 days. Mean stay in the hospital postoperatively was 7.7 days. 12 had type I Allman clavicle fracture, 5 had type IIA and 3 had type IIB. Only type II Goss scapular neck fracture with medial displacement >10mm and GPA <30◦ were included. Most of the patient had no major complications postoperatively. The mean time for radiological union of clavicle and scapula was found out to be 14.1 weeks and 8.9 weeks respectively. The mean Oxford shoulder score was 46.4 in 15 patients, 37.1in 3 patients and 27.3in 2 at the end of at least 9 months follow up.
Conclusion: Thesurgical fixation of all the floating shoulders, especially significantly displaced, allows for early rehabilitation and better functional outcome