Scapulothoracic dissociation.
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.
Ebraheim
N A
NA
Department of Orthopaedic Surgery, Medical College of Ohio, Toledo 43699.
An
H S
HS
Jackson
W T
WT
Pearlstein
S R
SR
Burgess
A
A
Tscherne
H
H
Hass
N
N
Kellam
J
J
Wipperman
B U
BU
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