Work

Scapulothoracic Dissociation in Contemporary Practice: Revisiting Clinical Reality Through the Trauma Quality Improvement Program

Year: 2026

Type: article

Abstract: Background Scapulothoracic dissociation is a rare, limb-, and potentially life-threatening injury in which the scapula and shoulder girdle are violently detached from the thoracic cage. However, the published data on the condition is mainly composed of case reports and single institution samples, which limits the overall generalizability. The aim of the current investigation was consequently to use a multi-institutional data set to characterize the injuries observed in patients with scapulothoracic dissociation along with the treatment strategies selected. Methods The 2016-2021 Trauma Quality Improvement Project (TQIP) database was used to identify cases of scapulothoracic dissociation. Patients were grouped based on the presence of neurovascular injury. The statistical significance of differences between the cohorts was determined using the Mann-Whitney U-test, chi-squared test, or Fisher’s exact test, as appropriate. Results After applying the inclusion criteria, 74 cases of scapulothoracic dissociation were detected in the TQIP database; of these, 20% (N = 15) also suffered a neurovascular injury. The majority of patients with scapulothoracic dissociation without neurovascular injury could be managed non-operatively, while this was only the case for a minority with neurovascular injury (71.2% vs 26.7%, P = 0.004). Among patients who were ≥60 years old without neurovascular injury (N = 13), 92.3% (N = 12) could be managed non-operatively. Of those with neurovascular injury, 46.7% required internal fixation, 40% underwent vascular surgery, and 20% necessitated upper arm or forequarter amputation. Conclusion While scapulothoracic dissociation can be a serious, debilitating injury, most cases don’t result in neurovascular injury and can often be managed non-operatively, particularly among the elderly.

Source: The American Surgeon

DOI: 10.1177/00031348261415623

Authors: Maximilian Peter Forssten, Ahmad Westas Ismail, Babak Sarani, Shahin Mohseni

Institutions: Örebro University, George Washington University, Jahra Hospital

Language: English

Topic: Trauma Management and Diagnosis

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $4,150