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Scapulothoracic dissociation: a rare injury with scapular comminuted fracture and intact clavicle

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Introduction

Scapulothoracic dissociation is a high-energy injury of the upper limb, often misdiagnosed due to associate traumas.

Material

The patient was a 37-year-old male who sustained a car accident. He was well oriented and classified as GS:15/15. He complained for a right arm pain and numbness and able to make small movements bellow elbow. A complete clinico-radiological examination was performed. Blood tests were normal except saturation which was declining. The patient collapsed in the emergency department and underwent emergency intubation.

Results

The patient had multiple right rib fractures, scapula comminuted fracture, lung distress syndrome, hemothorax and extensive hematoma around the right shoulder, right neck area and ventral thoracic wall. The increased scapulothoracic index confirmed the speculation of scapulothoracic dissociation. Conservative management was decided that time. Further investigation was requested just after the patient became stable, but he died 15 days later due to acute respiratory distress syndrome (ARDS).

Conclusion

Scapulothoracic dissociation is a rare injury, and the prognosis is mainly related with brachial plexus avulsion.

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Conflict of interest statement

No funds were received in support of this study.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Alexandroupolis University Hospital, 10th Timoleontos Vassou Street, 11521, Athens, Greece

    Efthimios J. Karadimas, Dimitrios Kotzamitelos, Eleni Babourda & Athanasios Hatzigiannakis

  2. First Department of Surgery, Democritus University in Thrace, Alexandroupolis, Greece

    John Siasios & Eleni Efraimidou

  3. Department of Radiology, Democritus University in Thrace, Alexandroupolis, Greece

    Savvas Defteraios

  4. Department of Plastic Surgery, Democritus University in Thrace, Alexandroupolis, Greece

    Despoina D. Kakagia

Authors
  1. Efthimios J. Karadimas
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  2. Dimitrios Kotzamitelos
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  3. John Siasios
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  4. Savvas Defteraios
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  5. Despoina D. Kakagia
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  6. Eleni Babourda
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  7. Eleni Efraimidou
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  8. Athanasios Hatzigiannakis
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Corresponding author

Correspondence to Efthimios J. Karadimas.

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Karadimas, E.J., Kotzamitelos, D., Siasios, J. et al. Scapulothoracic dissociation: a rare injury with scapular comminuted fracture and intact clavicle. Eur J Orthop Surg Traumatol 20, 151–155 (2010). https://doi.org/10.1007/s00590-009-0496-9

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  • DOI: https://doi.org/10.1007/s00590-009-0496-9

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