Floating Shoulder
(Ipsilateral Fractures of the Clavicle and Scapular Neck)
Definition
A floating shoulder is a break in the clavicle bone (collarbone) and the upper part of the scapula bone (shoulder blade). The shoulder pulls out of place and looks like it is floating.
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Causes
This injury is caused by trauma from:
- Motor vehicle or bike accidents
- Falls
- Being shot with a gun
- Crushing of the shoulder
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Risk Factors
Things that may raise the risk of this injury are:
- Not wearing a seat belt
- Being around violence
Symptoms
Symptoms may be:
- Pain
- Bruising
- Swelling
- Muscle spasms
- The arm of the injured shoulder hanging lower than normal
- Numbness or weakness
Diagnosis
The doctor will ask about your symptoms and health history. You will also be asked how the injury happened. A physical exam will be done. Your shoulder will be checked. You may need to see a doctor who treats bones.
Images may be taken of your shoulder. This can be done with:
Treatment
The problem is treated based on the level of injury. Options are:
Initial Care
Initial care may be:
- Ice to ease pain and swelling
- Medicine to ease pain
- A sling or shoulder immobilizer to keep the shoulder in place as it heals
- Exercises to help with strength and motion
Surgery
The clavicle may be repaired with surgery using a plate and screws. The scapular bone may also be fixed with surgery. A sling or shoulder immobilizer will be used to keep the shoulder in place.
Prevention
Many of these injuries happen due to motor vehicle accidents. Always wear a seat belt when riding in a car.
RESOURCES:
American Orthopaedic Society for Sports Medicine
http://www.sportsmed.org
Ortho Info—American Academy of Orthopaedic Surgeons
http://orthoinfo.aaos.org
CANADIAN RESOURCES:
Canadian Association of Emergency Physicians
http://www.caep.ca
Trauma Association of Canada
http://www.traumacanada.org
REFERENCES:
Clavicle fracture—emergency management. EBSCO DynaMed website. Available at:https://www.dynamed.com/management/clavicle-fracture-emergency-management/. Accessed September 20, 2019.
Kim W, McKee MD. Management of acute clavicle fractures. Orthop Clin North Am. 2008 Oct;39(4):491-505.
Questions and answers about shoulder problems. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: https://www.niams.nih.gov/health-topics/shoulder-problems. Updated April 2014. Accessed September 20, 2019.
Shoulder trauma (fractures and dislocations). Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00394. Updated September 2007. Accessed September 20, 2019.
Last reviewed September 2019 by EBSCO Medical Review Board Teresa Briedwell, PT, DPT, OCS, CSCS Last Updated: 7/14/2020