Workup
Laboratory Studies
- Laboratory studies include CBC, basic metabolic profile, and urinalysis.
Imaging Studies
- A chest radiograph, cervical spine series, and electrocardiogram often also are indicated based upon the history and physical examination findings.
- Specific radiographic evaluation of the shoulder injury should include plain radiographs of the clavicle and the shoulder trauma series (true anteroposterior view of the glenohumeral joint, axillary view, and scapular lateral view). If concern exists regarding an intraarticular extension of the scapular neck fracture or if the scapular neck fracture is inadequately depicted on the plain films, a CT scan of the scapula should be obtained.
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References
Owens BD, Goss TP. The floating shoulder. J Bone Joint Surg Br. Nov 2006;88(11):1419-24. [Medline].
DeFranco MJ, Patterson BM. The floating shoulder. J Am Acad Orthop Surg. Aug 2006;14(8):499-509. [Medline].
van Noort A, van der Werken C. The floating shoulder. Injury. Mar 2006;37(3):218-27. [Medline].
Davidson JJ. Floating shoulder injuries. Duke Orthopaedics presents Wheeles' Textbook of Orhtopaedics. Available at http://www.wheelessonline.com/ortho/floating_shoulder_injuries. Accessed March 31, 2009.
Herscovici D Jr, Fiennes AG, Allgower M, Rucdi TP. The floating shoulder: ipsilateral clavicle and scapular neck fractures. J Bone Joint Surg Br. May 1992;74(3):362-4. [Medline].
Kumar VP, Satku K. Fractures of clavicle and scapular neck. J Bone Joint Surg Br. May 1993;75(3):509. [Medline].
Goss TP. Double disruptions of the superior shoulder suspensory complex. J Orthop Trauma. 1993;7(2):99-106. [Medline].
Ada JR, Miller ME. Scapular fractures. Analysis of 113 cases. Clin Orthop. Aug 1991;(269):174-80. [Medline].
Rowe CR. Evaluation of the shoulder. In: Rowe CR, ed. The Shoulder. NY:. Churchill Livingstone;1988:631-637.
Leung KS, Lam TP. Open reduction and internal fixation of ipsilateral fractures of the scapular neck and clavicle. J Bone Joint Surg Am. Jul 1993;75(7):1015-8. [Medline].
Edwards SG, Whittle AP, Wood GW 2nd, et al. Nonoperative treatment of ipsilateral fractures of the scapula and clavicle. J Bone Joint Surg Am. Jun 2000;82(6):774-80. [Medline].
Ramos L, Mencia R, Alonso A, Ferrandez L. Conservative treatment of ipsilateral fractures of the scapula and clavicle. J Trauma. Feb 1997;42(2):239-42. [Medline].
Rikli D, Regazzoni P, Renner N. The unstable shoulder girdle: early functional treatment utilizing open reduction and internal fixation. J Orthop Trauma. Apr 1995;9(2):93-7. [Medline].
Kim KC, Rhee KJ, Shin HD, Yang JY. Can the glenopolar angle be used to predict outcome and treatment of the floating shoulder?. J Trauma. Jan 2008;64(1):174-8. [Medline].
Butters KP. The scapula. In: Rockwood CA Jr, Matsen FA, eds. The Shoulder. Vol 1. Philadelphia:. WB Saunders Co;1998:391-427.
Ganz R, Noesberger B. [Treatment of scapular fractures]. Hefte Unfallheilkd. Nov 1975;(126):59-62. [Medline].
Further Reading
Related eMedicine topics
Clavicle Fractures
Scapula Fracture
Clavicle, Fractures and Dislocations
Fracture, Scapular
Clinical guidelines
ACR Appropriateness Criteria® shoulder trauma. American College of Radiology - Medical Specialty Society. 1995 (revised 2005). 6 pages. NGC:004632
Clinical trials
Plating Clavicle Fractures
Operative Versus Nonoperative Treatment for Scapula Fractures
A Prospective, Randomised Long-Term Follow-up of Operative Versus Non-Operative Treatment of Gr. 3 Acromioclavicular Dislocation
Keywords
floating shoulder, ipsilateral fractures of the clavicle and scapular neck, clavicle fracture, scapula fracture
Workup: Floating Shoulder