Biomechanics Research of Surgical Internal Fixation Methods for General Floating Shoulder Injury_West China Medical Journal

Authors：

 DUANLian-hong ¹ ,  ZHANGPeng ¹ , HUANGJi-feng ² , ZHAOWei-dong ³ , CHENGLi ¹

1. Department of Orthopedics, Dongfeng Hospital, Hubei University of Medicine, Shiyan, Hubei 442008, P. R. China;
2. Department of Orthopedics, Wuhan General Hospital of Guangzhou Command, Wuhan, Hubei 430070, P. R. China;
3. Key Laboratory of Medical Biomechanics, Southern Medical University, Guangzhou, Guangdong 510515, P. R. China;

Corresponding?author：

ZHANGPeng, Email: 279499364@qq.com

Keywords：

Floating shoulder injury; Superior suspensory shoulder complex; Internal fixation; Biomechanics

DOI：

10.7507/1002-0179.20140614

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Objective To evaluate three commonly used internal fixations for general floating shoulder injury by biomechanical testing, in order to provide biomechanics basis for surgical choices. Methods The superior shoulder suspensory complex (SSSC) was anatomized from 7 cases of antisepsis cadaveric specimens including collarbone and scapula. In the man-made damage models, 4 statuses including prefixation, pure acromioclavicular joint fixation, acromioclavicular joint fixation with scapula neck single plate fixation, and acromioclavicular joint fixation with scapula neck double plate fixation were tested to measure the range of motion (ROM) and neutral zone (NZ) of scapula neck under different statuses by spinal motion analysis system, and stabilizing function of different fixations for instable SSSC were compared. Results The biomechanical testing showed that the NZs of acromioclavicular joint fixation with scapula neck double plate fixation were respectively flexion-extension (3.88±1.71)°, lateral-bending (1.89±0.21)°, and axial-torque (3.13±1.37)°, and the ROMs were respectively flexion-extension (12.91±4.82)°, lateral-bending (18.44±4.43)°, and axial-torque (11.27±4.41)°, which decreased more evidently than other fixation groups (P<0.05). Conclusion Acromioclavicular joint fixation with scapula neck double plate fixation is the best treatment for floating shoulder injury, which can restore the stability of the shoulder effectively.

Citation： DUANLian-hong, ZHANGPeng, HUANGJi-feng, ZHAOWei-dong, CHENGLi. Biomechanics Research of Surgical Internal Fixation Methods for General Floating Shoulder Injury. West China Medical Journal, 2014, 29(11): 2028-2031. doi: 10.7507/1002-0179.20140614 Copy

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2.	Goss TP. Double disruptions of the superior shoulder suspensory complex[J]. Orthop Trauma, 1993, 7(2):99-106.
3.	朱青安, 原林, 鐘世鎮, 等. 中、下部頸椎的三維運動[J]. 中國臨床解剖學雜志, 1992, 10(4):300-302, 320.
4.	Low CK, Lam AW. Results of fixation of clavicle alone in managing floating shoulder[J]. Singapore Med, 2000, 41(9):452-453.
5.	Hashiguchi H, Ito H. Clinical outcome of the treatment of floating shoulder by osteosynthesis for clavicular fracture alone[J]. J Shoulder Elbow Surg, 2003, 12(6):589-591.
6.	Labler L, Platz A, Weishaupt D, et al. Clinical and functional results after floating shoulder injuries[J]. J Trauma, 2004, 57(3):595-602.
7.	賈健, 裴福興, 郭錄增, 等. 浮肩損傷[J]. 中華骨科雜志, 2006, 26(5):294-299.
8.	Toro JB, Helfet DL. Surgical management of the floating shoulder[J]. Tech Shoulder Elbow Surg, 2004, 5(2):l16-121.
9.	Leung KS, Lam TP. Open reduction and internal fixation of ipsilateral fractures of the scapular neck and clavicle[J]. Bone Joint Surg Am, 1993, 75(7):1015-1018.
10.	Egol KA, Connor PM, Karunakar MA, et al. The floating shoulder:clinical and functional results[J]. J Bone Joint Surg Am, 2001, 83-A(8):1188-1194.
11.	盧小虎, 肖德明, 林博文, 等. 肩胛骨骨折合并鎖骨骨折治療方法探討[J]. 中華創傷雜志, 2005, 21(4):264-266.
12.	黃哲元, 陳長青, 郭林新, 等. 浮肩損傷的治療方法選擇[J]. 臨床骨科雜志, 2006, 9(6):528-530.
13.	郝毅, 楊文勛, 趙大正. 預彎雙鋼板治療肩胛頸骨折的影像學研究與臨床應用[J]. 中華創傷雜志, 2000, 16(3):173-175.
14.	李文基, 梁小軍, 程德根. 移位肩胛頸骨折的手術方法研究[J]. 中華醫學雜志, 2006, 86(23):1615-1619.

1. Herscovici D Jr, Fiennes AG, Allg?wer M, et al. The floating shoulder:ipsilateral clavicle and scapular neck fractures[J]. J Bone Joint Surg Br, 1992, 74(3):362-364.
2. Goss TP. Double disruptions of the superior shoulder suspensory complex[J]. Orthop Trauma, 1993, 7(2):99-106.
3. 朱青安, 原林, 鐘世鎮, 等. 中、下部頸椎的三維運動[J]. 中國臨床解剖學雜志, 1992, 10(4):300-302, 320.
4. Low CK, Lam AW. Results of fixation of clavicle alone in managing floating shoulder[J]. Singapore Med, 2000, 41(9):452-453.
5. Hashiguchi H, Ito H. Clinical outcome of the treatment of floating shoulder by osteosynthesis for clavicular fracture alone[J]. J Shoulder Elbow Surg, 2003, 12(6):589-591.
6. Labler L, Platz A, Weishaupt D, et al. Clinical and functional results after floating shoulder injuries[J]. J Trauma, 2004, 57(3):595-602.
7. 賈健, 裴福興, 郭錄增, 等. 浮肩損傷[J]. 中華骨科雜志, 2006, 26(5):294-299.
8. Toro JB, Helfet DL. Surgical management of the floating shoulder[J]. Tech Shoulder Elbow Surg, 2004, 5(2):l16-121.
9. Leung KS, Lam TP. Open reduction and internal fixation of ipsilateral fractures of the scapular neck and clavicle[J]. Bone Joint Surg Am, 1993, 75(7):1015-1018.
10. Egol KA, Connor PM, Karunakar MA, et al. The floating shoulder:clinical and functional results[J]. J Bone Joint Surg Am, 2001, 83-A(8):1188-1194.
11. 盧小虎, 肖德明, 林博文, 等. 肩胛骨骨折合并鎖骨骨折治療方法探討[J]. 中華創傷雜志, 2005, 21(4):264-266.
12. 黃哲元, 陳長青, 郭林新, 等. 浮肩損傷的治療方法選擇[J]. 臨床骨科雜志, 2006, 9(6):528-530.
13. 郝毅, 楊文勛, 趙大正. 預彎雙鋼板治療肩胛頸骨折的影像學研究與臨床應用[J]. 中華創傷雜志, 2000, 16(3):173-175.
14. 李文基, 梁小軍, 程德根. 移位肩胛頸骨折的手術方法研究[J]. 中華醫學雜志, 2006, 86(23):1615-1619.

West China Medical Journal

Biomechanics Research of Surgical Internal Fixation Methods for General Floating Shoulder Injury

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