[Extended surgical indications in combined shoulder girdle fracture].

The combination of an ipsilateral clavicule and scapula fracture causes a double instability of the shoulder. In opposite to an isolated clavicule or scapula fracture this injury should be treated operatively. Diagnosis of the scapula fracture in polytrauma can be difficult. If there is a clinical or radiologic suspicion, the indication for a CT scan is given. Osteosynthesis with plates from separated approaches, first the scapula from dorsal then the calvicule from ventral has proven good. The nervus suprascapularis must be treated carefully and, if necessary, liberated from the fracture. The optimal treatment of this injury is not always possible in polytraumatised patient.