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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 look like it is floating.

Bones of the Shoulder
shoulder anatomy

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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

Shoulder Injury During Car Crash
car accident shoulder injury

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Risk Factors

Things that may raise the risk of this injury are:

  • Not wearing a seatbelt
  • 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 seatbelt 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: 9/20/2019