title: Floating shoulders: Clinical and radiographic analysis at a mean follow-up of 11 years.
abstract: BACKGROUND
  The floating shoulder (FS) is an uncommon injury, which can be managed conservatively or surgically. The therapeutic option remains controversial.
  
  
  OBJECTIVE
  The goal of our study was to evaluate the long-term results and to identify predictive factors of functional outcomes.
  
  
  METHODS
  Retrospective monocentric study.
  
  
  METHODS
  Forty consecutive FS were included (24 nonoperated and 16 operated) from 1984 to 2009. Clinical results were assessed with Simple Shoulder Test (SST), Oxford Shoulder Score (OSS), Single Assessment Numeric Evaluation (SANE), Short Form-12 (SF12), Disabilities of the Arm Shoulder and Hand score (DASH), and Constant score (CST). Plain radiographs were reviewed to evaluate secondary displacement, fracture healing, and modification of the lateral offset of the gleno-humeral joint (chest X-rays). New radiographs were made to evaluate osteoarthritis during follow-up.
  
  
  METHODS
  T-test, Mann-Whitney test, and the Pearson's correlation coefficient were used. The significance level was set at 0.05.
  
  
  RESULTS
  At mean follow-up of 135 months (range 12-312), clinical results were satisfactory regarding different mean scores: SST 10.5 points, OSS 14 points, SANE 81%, SF12 (50 points and 60 points), DASH 14.5 points and CST 84 points. There were no significant differences between operative and non-operative groups. However, the loss of lateral offset influenced the results negatively. Osteoarthritis was diagnosed in five patients (12.5%) without correlation to fracture patterns and type of treatment.
  
  
  CONCLUSIONS
  This study advocates that floating shoulder may be treated conservatively and surgically with satisfactory clinical long-term outcomes. However, the loss of gleno-humeral lateral offset should be evaluated carefully before taking a therapeutic option.
authors: Department of Orthopeadic and Traumatology, Musculoskeletal Institute, Toulouse, France.
authors: Reì Gis
authors: RG
authors: Pailhes
authors: Nicolas
authors: N
authors: Bonnevialle
authors: Jeanmichel
authors: J
authors: Laffosse
authors: Jeanlouis
authors: J
authors: Tricoire
authors: Etienne
authors: E
authors: Cavaignac
authors: Philippe
authors: P
authors: Chiron
keywords: Arthritis; clavicle; floating shoulder; fracture; scapula
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