Management of floating shoulder injury with dual surgical approach

Abstract

The aesthetic appearance of the thumb hasn't been analysed to a similar extent as thumb function which would aid during reconstructive surgeries of the thumb and first web space and analyse its outcome. The purpose of this study is to determine the relative length, girth, nail width of thumb with respect to the index finger and intermetacarpal distance. Measurement of the 1 st web space arc radius has been done to tackle the problem of webbing which is not addressed by IMD and palmar abduction angles. A total of 482 hands in 241 subjects were studied to measure the relative length of the thumb with respect to the index finger, the relative nail width of thumb with respect to index finger, the relative girth of IP joint of thumb with respect to PIP joint of index finger and Intermetacarpal distance was calculated. The 1 st web space arc radius was calculated by the "best arc fit" with the thumb in maximum radial abduction using a radius gauge. The data collected was analysed by age, gender, laterality of the hand and the height and weight of the child. Hands of subjects of which with a mean age of years were analysed. The relative Thumb length, girth and nail width remained independent of age. It has been observed that the reliability of the measurements between the right and left web space arc radius measurement is significant . The provided would help reconstructive surgeons analyse aesthetic outcomes of reconstructive surgeries intraoperatively and post operatively. A correlation between the 1 st web space arc radius of right and left hands would help predict the expected post-operative outcome.

Clinical Outcome After Operative Treatment in Floating Shoulder- A Prospective Study

“…This reduces the risk of non-union, alleviates tension on the brachial plexus, restores normal anatomical relationships and ensures restoration of normal shoulder function. 6,26 They came out with a concept that fracture of glenoid neck will indirectly reduce and stabilize as a result of clavicle fixation. However, if significant displacement of glenoid neck persists, it should be reduced and fixed.…”

“…double disruption), the integrity of the superior shoulder suspensory complex is breached and a potentially anatomically unstable situation is created. 6 In such situation the weight of the arm and the muscles acting on the humerus pull the glenoid fragment distally and anteromedially which results into drooping of shoulder followed by nonunion, malunion, brachial plexopathy, limited range of motion, weakness in abduction and subacromial impingement. 7 Williams et al in a cadaveric study observed that in ipsilateral glenoid neck and clavicular fractures, instability of the glenoid segment occurred only if the coracoacromial and acromioclavicular ligaments were divided.…”