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The Journal of Cardiovascular Surgery 2000 December;41(6):927-9

Copyright © 2009 EDIZIONI MINERVA MEDICA

lingua: Inglese

Traumatic scapulothoracic dissociation

Witz M., Korzets Z., Lehmann J.

From the Vascular Surgery Unit *Department of Nephrology, Meir General Hospital, Kfar Saba, affiliated to Tel-Aviv University Sackler School of Medicine, Tel-Aviv, Israel


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Scap­u­loth­o­racic dis­so­ci­a­tion is an infre­quent ­injury ­with a poten­tially dev­as­tating out­come. The diag­nosis is ­based on clin­ical and radio­graphic find­ings of fore­quarter dis­rup­tion. ­These ­include mas­sive ­soft ­tissue ­swelling of the ­shoulder, dis­place­ment of the ­scapula and neu­ro­vas­cular inju­ries (bra­chial ­plexus, sub­cla­vian ­artery and ­osseous-lig­a­men­tous inju­ries). The mech­a­nism of ­injury ­appears to be the ­delivery of ­severe rota­tional ­force ­sheering the ­shoulder ­girdle ­from its ­chest ­wall attach­ments ­around the ­scapula, ­shoulder ­joint and at the clav­icle. ­Early rec­og­ni­tion of the ­entity and aggres­sive treat­ment are cru­cial. Out­come is not depen­dent on man­age­ment of the arte­rial ­injury, but ­rather on the ­severity of the neu­ro­log­ical def­icit.

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