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Fracture dislocation of scapulothoracic joint

Last edited: 4/15/2026

Overview

Fracture dislocation of the scapulothoracic joint involves a traumatic disruption of the articulation between the scapula and the thoracic wall, often resulting from high-energy injuries and leading to significant shoulder dysfunction 1.

Diagnosis

  • Key Diagnostic Criteria: Presence of shoulder pain, deformity, and limited range of motion post-trauma 1.
  • Recommended Tests:
    • - Imaging: CT and MRI are crucial for detailed assessment of bony and soft tissue injuries 1. - Plain X-rays: Initial screening tool, though may not fully capture all injuries 1.
  • Grading: Not universally standardized; clinical severity often guides management 1.

    • Management

  • First-Line Treatments:
    • - Surgical Intervention: Indicated for unstable fractures or significant soft tissue injuries 1. - Closed Reduction: For stable injuries, aiming to restore anatomical alignment 1.
  • Adjunctive Treatments:
    • - Immobilization: Use of slings or casts to stabilize the shoulder post-reduction 1. - Physical Therapy: Gradual rehabilitation to restore function and strength 1.

    Special Populations

  • Pregnancy: Management focuses on minimizing radiation exposure; imaging choices should consider fetal safety 1.
  • Pediatrics: Growth plate considerations necessitate careful surgical approaches to avoid growth disturbances 1.
  • Elderly: Emphasis on conservative management due to higher risk of complications from surgery 1.
  • Comorbidities: Tailored treatment plans considering cardiovascular, pulmonary, and other systemic health conditions 1.

    • Key Recommendations

  • Immediate imaging with CT and MRI for comprehensive assessment (Evidence: Moderate 1).
  • Surgical intervention for unstable fractures to ensure anatomical reduction and stability (Evidence: Expert opinion 1).
  • Initiate physical therapy post-immobilization to optimize functional recovery (Evidence: Moderate 1).

    • References

    1 Verma N, Linnau KF. Core curriculum illustration: scapulothoracic disassociation. Emergency radiology 2015. link

    Original source

    1. [1]
      Core curriculum illustration: scapulothoracic disassociation. — Verma N, Linnau KF Emergency radiology (2015)
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