Scapulothoracic dissociation: Difference between revisions
ClaireLewis (talk | contribs) No edit summary |
(Text replacement - "-->" to "→") |
||
| Line 8: | Line 8: | ||
*Swelling, ecchymosis to shoulder | *Swelling, ecchymosis to shoulder | ||
*Injury to subclavian or axillary arteries: hematoma, pulse deficit | *Injury to subclavian or axillary arteries: hematoma, pulse deficit | ||
*Severe mechanism | *Severe mechanism → often associated with [[chest trauma]] | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
| Line 23: | Line 23: | ||
==Management== | ==Management== | ||
*Any evidence of neuro or vascular damage, hemodynamic | *Any evidence of neuro or vascular damage, hemodynamic instability→ surgery | ||
*Normal neuro exam, no vascular injury: immobilization, supportive care | *Normal neuro exam, no vascular injury: immobilization, supportive care | ||
Latest revision as of 19:28, 8 February 2017
Background
- Traumatic dislocation of scapula from thoracic wall
- Mechanism: massive traction force to ipsilateral upper extremity/shoulder girdle
- Associated with vascular injury to subclavian or axillary artery and brachial plexus injury
Clinical Features
- Upper extremity pain
- Upper extremity numbness/tingling, weakness
- Swelling, ecchymosis to shoulder
- Injury to subclavian or axillary arteries: hematoma, pulse deficit
- Severe mechanism → often associated with chest trauma
Differential Diagnosis
Thoracic Trauma
- Airway/Pulmonary
- Cardiac/Vascular
- Musculoskeletal
- Other
Evaluation
- CXR
- Laterally displaced scapula
- Associated with distracted clavicle fracture, AC spearation, sternoclavicular dislocation
- CT Chest
- To identify intrathoracic injuries
- CT Angio
- To detect vascular injuries
Management
- Any evidence of neuro or vascular damage, hemodynamic instability→ surgery
- Normal neuro exam, no vascular injury: immobilization, supportive care
Disposition
See Also
- Clavicle fracture
- Sternoclavicular dislocation
- Scapula fracture
- Brachial plexus injury
- Vascular injury