Scapulothoracic Dissociation - Everything You Need To Know - Dr. Nabil Ebraheim

Dr. Ebraheim’s educational animated video describes the condition of scapulothoracic dissociation.
Scapulothoracic Dissociation is a rare entity that consists of disruption of the Scapulothoracic articulation.
It is a traumatic lateral displacement of the scapula with intact skin. It has been described as closed, traumatic for-quarter amputation.
Closed avulsion of the scapula with associated clavicular fracture, sternoclavicular disruption or acromioclavicular separation.
Arteriography should be performed to diagnose vascular injury. Reduced pulses or no pulses in the extremity.
Most often there is varying degrees of injury to the brachial plexus and the subclavian artery resulting in flial, pulseless upper extremity.
This injury can be missed. Chest x-ray shows significant lateral displacement of the scapula. Can be associated with upper extremity fractures such as fractures of the scapula, clavicle and humerus.
Treatment
•Advanced trauma life support-airway, breathing, circulation.
•Angiography and repair of the artery if needed.
•Early above elbow amputation and shoulder fusion based on the degree of neurovascular and scapular muscle damage.

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