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The Journal of Bone and Joint Surgery, Vol 70, Issue 3 428-432, Copyright © 1988 by Journal of Bone and Joint Surgery, Inc

JOURNAL CONTENTS

Scapulothoracic dissociation

NA Ebraheim, HS An, WT Jackson, SR Pearlstein, A Burgess, H Tscherne, N Hass, J Kellam and BU Wipperman
Department of Orthopaedic Surgery, Medical College of Ohio, Toledo 43699.

Scapulothoracic dissociation is a rare entity that consists of disruption of the scapulothoracic articulation. The mechanism of injury is probably traction caused by a blunt force to the shoulder girdle. This lesion is characterized by massive soft-tissue swelling of the shoulder; lateral displacement of the scapula, measured radiographically; an injury to bone (an acromioclavicular separation, a displaced fracture of the clavicle, or a sternoclavicular disruption); a severe neurovascular injury; and a variety of upper and lower-extremity fractures. We treated fifteen patients who had this lesion, most of whom had several associated injuries. Three patients died: two from exsanguination and one from a cardiac arrest. In most patients, the damaged artery was repaired and the brachial plexus was explored. All of the twelve patients who had a complete brachial-plexus injury were left with a flail upper extremity. Most patients refused amputation.
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