title: Scapulothoracic dissociation.
abstract: 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.
authors.affiliation: Department of Orthopaedic Surgery, Medical College of Ohio, Toledo 43699.
authors.forename: N A
authors.initials: NA
authors.lastname: Ebraheim
authors.forename: H S
authors.initials: HS
authors.lastname: An
authors.forename: W T
authors.initials: WT
authors.lastname: Jackson
authors.forename: S R
authors.initials: SR
authors.lastname: Pearlstein
authors.forename: A
authors.initials: A
authors.lastname: Burgess
authors.forename: H
authors.initials: H
authors.lastname: Tscherne
authors.forename: N
authors.initials: N
authors.lastname: Hass
authors.forename: J
authors.initials: J
authors.lastname: Kellam
authors.forename: B U
authors.initials: BU
authors.lastname: Wipperman
mesh_terms: D000173:Acromioclavicular Joint / Q000000981:diagnostic imaging / Q000293:injuries; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009132:Muscles / Q000293:injuries; D011859:Radiography; D012540:Scapula / Q000000981:diagnostic imaging / Q000293:injuries*; D013247:Sternoclavicular Joint / Q000000981:diagnostic imaging / Q000293:injuries