Floating shoulder

Abstract

This chapter discusses the floating shoulder (scapular neck fracture which became inherently unstable by losing its osseoligamentous connections to the axial skeleton), presenting a thorough analysis of their definition, epidemiology, anatomy, biomechanics, injury mechanisms, diagnosis, classifications, treatment modalities, complications, and outcomes. We provide a detailed description of the superior shoulder suspensory complex (SSSC) to elucidate the pivotal role of ligamentous integrity in shoulder stability. We place emphasis on recent advancements, particularly the shift toward a conservative approach in managing isolated scapular neck fractures. Drawing from contemporary literature, the chapter advocates for prioritizing the evaluation of shoulder girdle stability before surgical intervention. We discuss the importance of using a functional classification system based on ligament integrity to guide decision-making for patients with floating shoulder. We underscore the importance of converting a floating shoulder into an isolated scapular fracture, thereby minimizing complications in high-energy trauma cases. This comprehensive overview offers valuable insights for clinicians and researchers that interact or investigate the diagnosis and management of patients with floating shoulder.