Muhamed Fuad Mohd Afiq, Ariffin Kamarul, Ab Halim Ashraf Hakim
Orthopaedic/Advance Musculoskeletal Trauma, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, MYS.
Orthopaedics, Hospital Sultan Idris Shah, Selangor, MYS.
Cureus. 2025 Jul 21;17(7):e88478. doi: 10.7759/cureus.88478. eCollection 2025 Jul.
Floating shoulder injuries are rare but require careful management to ensure functional recovery. Traditional approaches for scapular fixation often necessitate multiple incisions. We present a modification of the direct lateral approach that allows for scapular lateral border and scapular spine fixation using a single incision with utilization of subdeltoid space. A 48-year-old male patient presented with a displaced extra-articular scapular fracture associated with a midshaft clavicle fracture following a motor vehicle accident. The patient underwent open reduction and internal fixation (ORIF) using a standard anterior approach for the clavicle and a modified direct lateral approach for the scapula. This technique eliminated the need for a secondary incision while ensuring stable fixation and preserving deltoid origin without the need for detachment. Postoperatively, the patient demonstrated excellent range of motion without complications up till his one-year follow-up. This case highlights a less invasive yet effective technique for scapular fixation in floating shoulder injuries.
浮动肩损伤很少见，但需要仔细处理以确保功能恢复。传统的肩胛骨固定方法通常需要多个切口。我们提出了一种改良的直接外侧入路，该入路允许通过利用三角肌下间隙的单一切口进行肩胛骨外侧缘和肩胛冈固定。一名48岁男性患者在机动车事故后出现了与锁骨中段骨折相关的关节外移位肩胛骨骨折。该患者采用标准的锁骨前路和改良的肩胛骨直接外侧入路进行切开复位内固定（ORIF）。该技术消除了二次切口的需要，同时确保了稳定的固定，并保留了三角肌起点而无需分离。术后，该患者直至1年随访时均表现出良好的活动范围且无并发症。该病例突出了一种用于浮动肩损伤肩胛骨固定的微创但有效的技术。
