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Anatomic Restoration of Triple Disruption of the Superior Shoulder Suspensory Complex: A Case Report and Review of the Literature

BACKGROUND: Multiple disruptions of the superior shoulder suspensory complex (SSSC) involving more than two components are extremely rare. In some extreme situations, three components of the SSSC structure can be involved. The ideal treatment for this type of injury is debatable. CASE PRESENTATION:...

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Autores principales: Wu, Kai, Wu, Xiao‐ming, Zha, Xiao‐long, Wang, Qiu‐gen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons Australia, Ltd 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7670163/
https://www.ncbi.nlm.nih.gov/pubmed/32975039
http://dx.doi.org/10.1111/os.12764
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author Wu, Kai
Wu, Xiao‐ming
Zha, Xiao‐long
Wang, Qiu‐gen
author_facet Wu, Kai
Wu, Xiao‐ming
Zha, Xiao‐long
Wang, Qiu‐gen
author_sort Wu, Kai
collection PubMed
description BACKGROUND: Multiple disruptions of the superior shoulder suspensory complex (SSSC) involving more than two components are extremely rare. In some extreme situations, three components of the SSSC structure can be involved. The ideal treatment for this type of injury is debatable. CASE PRESENTATION: A 21‐year‐old woman was referred to our emergency center following a traffic accident. A three‐dimensional CT scan showed triple disruption of the SSSC involving concomitant ipsilateral fractures of the coracoid, the acromion, and the distal clavicle. The connection between the upper limber and the axial skeleton was destroyed. There was no evidence of associated injury and the neurovascular examination of the injured upper limb was normal. The patient underwent an open reduction and internal fixation to restore the anatomic integrity of the SSSC. The arm was supported in a broad arm sling for 2 weeks after surgery. Gentle passive range of motion activity under analgesic was encouraged from the second day postoperatively. One year and half after the operation, the patient had regained pain free and unrestricted shoulder stability and mobility. CONCLUSION: The manifestations of multiple disruptions of the SSSC may be variable. This case illustrated the challenges of treating the multiple disruption of the SSSC structure. It also showed that surgical intervention for this rare combination injury yields an excellent functional result. The good outcome achieved in this patient demonstrates that surgical intervention might be an optional resolution for multiple disruptions of the SSSC.
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spelling pubmed-76701632020-11-23 Anatomic Restoration of Triple Disruption of the Superior Shoulder Suspensory Complex: A Case Report and Review of the Literature Wu, Kai Wu, Xiao‐ming Zha, Xiao‐long Wang, Qiu‐gen Orthop Surg Case Reports BACKGROUND: Multiple disruptions of the superior shoulder suspensory complex (SSSC) involving more than two components are extremely rare. In some extreme situations, three components of the SSSC structure can be involved. The ideal treatment for this type of injury is debatable. CASE PRESENTATION: A 21‐year‐old woman was referred to our emergency center following a traffic accident. A three‐dimensional CT scan showed triple disruption of the SSSC involving concomitant ipsilateral fractures of the coracoid, the acromion, and the distal clavicle. The connection between the upper limber and the axial skeleton was destroyed. There was no evidence of associated injury and the neurovascular examination of the injured upper limb was normal. The patient underwent an open reduction and internal fixation to restore the anatomic integrity of the SSSC. The arm was supported in a broad arm sling for 2 weeks after surgery. Gentle passive range of motion activity under analgesic was encouraged from the second day postoperatively. One year and half after the operation, the patient had regained pain free and unrestricted shoulder stability and mobility. CONCLUSION: The manifestations of multiple disruptions of the SSSC may be variable. This case illustrated the challenges of treating the multiple disruption of the SSSC structure. It also showed that surgical intervention for this rare combination injury yields an excellent functional result. The good outcome achieved in this patient demonstrates that surgical intervention might be an optional resolution for multiple disruptions of the SSSC. John Wiley & Sons Australia, Ltd 2020-09-25 /pmc/articles/PMC7670163/ /pubmed/32975039 http://dx.doi.org/10.1111/os.12764 Text en © 2020 The Authors. Orthopaedic Surgery published by Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Reports
Wu, Kai
Wu, Xiao‐ming
Zha, Xiao‐long
Wang, Qiu‐gen
Anatomic Restoration of Triple Disruption of the Superior Shoulder Suspensory Complex: A Case Report and Review of the Literature
title Anatomic Restoration of Triple Disruption of the Superior Shoulder Suspensory Complex: A Case Report and Review of the Literature
title_full Anatomic Restoration of Triple Disruption of the Superior Shoulder Suspensory Complex: A Case Report and Review of the Literature
title_fullStr Anatomic Restoration of Triple Disruption of the Superior Shoulder Suspensory Complex: A Case Report and Review of the Literature
title_full_unstemmed Anatomic Restoration of Triple Disruption of the Superior Shoulder Suspensory Complex: A Case Report and Review of the Literature
title_short Anatomic Restoration of Triple Disruption of the Superior Shoulder Suspensory Complex: A Case Report and Review of the Literature
title_sort anatomic restoration of triple disruption of the superior shoulder suspensory complex: a case report and review of the literature
topic Case Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7670163/
https://www.ncbi.nlm.nih.gov/pubmed/32975039
http://dx.doi.org/10.1111/os.12764
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