Traumatic lateral scapular displacement: an expanded spectrum of associated neurovascular injury.
The clinical entity of "scapulothoracic dissociation" has been reported as an uncommon but devastating shoulder girdle disruption. All previously identified closed injuries have been associated with arterial and brachial plexus compromise; therefore, neurovascular disruption has been presented as an essential diagnostic clinical finding of scapulothoracic dissociation. We have identified and managed four patients who satisfy all the radiographic criteria for scapulothoracic dissociation but who have presented with a spectrum of neurovascular conditions ranging from entirely normal to complete disruption. These patients illustrate a previously unrecognized, or at least unreported, continuum of potential neurovascular compromise associated with disruption of the scapulothoracic articulation. An expanded and more descriptive classification scheme for "traumatic lateral scapular displacement" is proposed to emphasize the spectrum of possible presentations of this injury.
Division of Orthopedic Surgery, University of Wisconsin Hospital and Clinics, Madison 53792.
R H
RH
Lange
S H
SH
Noel
D000293:Adolescent; D000328:Adult; D000792:Angiography; D001917:Brachial Plexus / Q000293:injuries*; D002968:Clavicle / Q000293:injuries*; D005260:Female; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000145:classification / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D004204:Joint Dislocations / Q000145:classification / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy; D008297:Male; D009104:Multiple Trauma / Q000145:classification / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy; D009989:Orthotic Devices; D026741:Physical Therapy Modalities; D016059:Range of Motion, Articular; D012540:Scapula / Q000293:injuries*; D000070599:Shoulder Injuries; D013247:Sternoclavicular Joint / Q000293:injuries*; D013348:Subclavian Artery / Q000293:injuries*; D014057:Tomography, X-Ray Computed; D014949:Wounds, Nonpenetrating / Q000145:classification / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy