The classification and surgical treatment strategy of double disruption of the superior shoulder suspensory complex.

Objective To discuss the clinical characteristics of different types of double disruption of the superior shouhter suspensory complex (SSSC) and their surgical treatment strategy. Methods Fifteen cases with double disruption of the SSSC between May 2006 and March 2008 were retrospectively evaluated. There were 13 males and 2 females with an average age of 40.1 (20-55) years. There were seven cases of type Ⅰ which involved the scapular neck fracture combined with ipsilateral clavicular fracture; one case of type Ⅱ which involved the clavicular-coracoclavicular ligamentous-coracoid(C4) linkage injury; six cases of type Ⅲ which involved acromion-upper glenoid-coracoid fracture; one case of type Ⅳ which involved the clavicular-acromioclavicular joint-acromial strut injury. Twelve patients were treated operatively while the remaining three with critical associated injuries were treated conservatively. The clinical outcomes were evaluated according to the Constant score, Rowe score and Herscovici score. Results All cases were followed for an average of 13.2 (6-24) months. All fractures healed for a mean time of 10.2 (8-12) weeks. The mean Constant score for the surgical group was 91.3. The mean Rowe score for the surgical group was 92.9. The mean Herscovici score was 14.6. Conclusion The classification of double disruption of SSSC injury was established on Goss" description. The surgical treatment should restore the integrity and stability of the SSSC in order to maintain the shoulder girdle function. Key words: Wounds and injuries; Acromion; Scapula; Shoulder fractures; Fracture fixation,internal