Floating Shoulder

(Ipsilateral Fractures of the Clavicle and Scapular Neck)

by Cynthia M. Johnson, MA

Definition

Causes

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.

Bones of the Shoulder

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

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

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