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 A...

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Main Authors: Kai Wu, Xiao‐ming Wu, Xiao‐long Zha, Qiu‐gen Wang
Format: Article
Language:English
Published: Wiley 2020-10-01
Series:Orthopaedic Surgery
Subjects:
Online Access:https://doi.org/10.1111/os.12764
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author Kai Wu
Xiao‐ming Wu
Xiao‐long Zha
Qiu‐gen Wang
author_facet Kai Wu
Xiao‐ming Wu
Xiao‐long Zha
Qiu‐gen Wang
author_sort Kai Wu
collection DOAJ
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 doaj.art-f4a480cd58194c2eb47fb5a3861dcbc32022-12-21T17:56:23ZengWileyOrthopaedic Surgery1757-78531757-78612020-10-011251526153010.1111/os.12764Anatomic Restoration of Triple Disruption of the Superior Shoulder Suspensory Complex: A Case Report and Review of the LiteratureKai Wu0Xiao‐ming Wu1Xiao‐long Zha2Qiu‐gen Wang3Department of Trauma Orthopaedics Shanghai General Hospital Affiliated to Jiaotong University Shanghai ChinaDepartment of Trauma Orthopaedics Shanghai General Hospital Affiliated to Jiaotong University Shanghai ChinaDepartment of Trauma Orthopaedics Shanghai General Hospital Affiliated to Jiaotong University Shanghai ChinaDepartment of Trauma Orthopaedics Shanghai General Hospital Affiliated to Jiaotong University Shanghai ChinaBackground 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.https://doi.org/10.1111/os.12764TripleDisruptionSuperior shoulder suspensory complexRestoration
spellingShingle Kai Wu
Xiao‐ming Wu
Xiao‐long Zha
Qiu‐gen Wang
Anatomic Restoration of Triple Disruption of the Superior Shoulder Suspensory Complex: A Case Report and Review of the Literature
Orthopaedic Surgery
Triple
Disruption
Superior shoulder suspensory complex
Restoration
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 Triple
Disruption
Superior shoulder suspensory complex
Restoration
url https://doi.org/10.1111/os.12764
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