Complex Injury Patterns of the Shoulder Girdle -Three or Four-site Injuryby

Abstract

We showed the classification of the complex injury patterns of the shoulder girdle and reported on the clinical results of the treatment for the severe complex injury including a three or four site injury. We classified the shoulder girdle injuries into 4 sites as follows: (1) Injury around the acromio-clavicular ligament (2) Injury around the coraco-clavicular ligament (3) A scapular neck fracture (4) A mid-clavicular fracture. Complex injuries were classified with a combination of these. The patients with a three or four site injury, consisted of five men and two women with a mean age of fifty-nine point seven years old (sixteen to seventy-eight). The patterns of injuries were as follows: four cases of (1)+(2)+(4), one case of (1)+(2)+(3), two cases of (1)+(2)+(3)+(4). We performed surgically in two injury sites in four cases, and one injury site in two cases. We did conservative management in one case. In one case with conservative management, there remained a clavicular nonunion without few complaints. In one case with one injury-site fixation, there remained a nonunion of both the acromion and the coracoid process with motion pain. In cases of significantly displaced three or four site injury of the shoulder girdle, it was difficult to get the tight fixation with conservative managements: So we needed surgical reconstructions of at least two injury sites. In case of needing to reconstruct, we recommend to try reduction and fixation of each fracture because ligament reconstruction is difficult.