The floating shoulder: Clinical and functional results

Citation
Ka. Egol et al., The floating shoulder: Clinical and functional results, J BONE-AM V, 83A(8), 2001, pp. 1188-1194
Citations number
15
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Ortopedics, Rehabilitation & Sport Medicine","da verificare
Journal title
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME
ISSN journal
0021-9355 → ACNP
Volume
83A
Issue
8
Year of publication
2001
Pages
1188 - 1194
Database
ISI
SICI code
0021-9355(200108)83A:8<1188:TFSCAF>2.0.ZU;2-0
Abstract
Background: Displaced ipsilateral fractures of the clavicle and the glenoid neck are a complex injury pattern that is usually the result of high-energ y trauma. The treatment of these injuries is controversial, as good results have been reported with both operative and nonoperative treatment. Methods: Nineteen patients who had sustained a displaced fracture of the gl enoid neck with an ipsilateral clavicular fracture or acromioclavicular sep aration (floating shoulder) were retrospectively evaluated. The treatment w as nonoperative in twelve patients and operative in seven. At the time of f inal follow-up, standard radiographs were made and all patients were examin ed by a physical therapist and either a fellowship-trained shoulder surgeon or an orthopaedic traumatologist. In addition, each patient responded to t hree different validated objective functional outcome measures: the Short F orm-36, the American Shoulder and Elbow Surgeons Shoulder Scale, and the Di sabilities of the Arm, Shoulder and Hand Questionnaire. Isokinetic strength -testing was performed, and strength in internal and external rotation was compared with that of the uninvolved shoulder. The main outcome measures in cluded fracture-healing, functional outcome, patient satisfaction, and musc ular strength. Results: With regard to range of motion, only the amount of forward flexion was found to be significantly greater in the operatively treated group (p = 0.03). The operatively treated shoulders were found to be weaker in exter nal rotation at 300 degrees /sec and weaker in internal rotation at 180 deg rees /sec. When normalized to hand dominance, however, the numbers were too small to identify any significant difference. There was no significant dif ference between groups with regard to the three functional outcome measures . Conclusions: Good results may be seen both with and without operative treat ment. Therefore, we cannot universally recommend operative treatment for a double disruption of the superior suspensory shoulder complex. Treatment mu st be individualized for each patient.