Multiple disruptions of superior suspensory shoulder complex: A case report

Int J Surg Case Rep. 2024 Nov:124:110385. doi: 10.1016/j.ijscr.2024.110385. Epub 2024 Sep 30.

Abstract

Introduction: The superior shoulder suspensory complex (SSSC) is a ligamentous anatomical structure that maintains shoulder girdle stability. It comprises a ring of bones and tissues, including the glenoid fossa, coracoid process (CP), coracoclavicular ligaments, distal clavicle, acromioclavicular (AC) joint, and acromion. Goss first described the structure in 1993. Disruption in two or more structures results in an unstable lesion. This report presents a rare case of triple disruption of the acromion, CP, and AC joint. Triple disruption of the SSSC is uncommon; therefore, the treatment is debatable. In our case, surgical intervention was performed to fix the instability of the shoulder girdle, which improved the patient's shoulder function.

Case presentation: A 43-year-old woman presented with an acromial fracture, a CP fracture, and dislocation of the AC joint after a traffic accident. The patient underwent surgery and postoperative rehabilitation.

Discussion: Several treatment options exist for multiple disruptions of the shoulder stabilizing SSSC, including K-wire fixation, plate fixation, or arthroscopic-assisted devices. As the patient's acromion size was smaller than the average female acromion, K-wire fixation was deemed the most suitable method.

Conclusion: Multiple disruptions of the SSSC are rare and typically result from high-velocity injuries. Surgical treatment should be tailored to the specific injury patterns and the individual patient's condition.

Keywords: Case report; Multiple disruption of SSSC.

Publication types

  • Case Reports