J Korean Orthop Assoc.  2011 Feb;46(1):68-72. 10.4055/jkoa.2011.46.1.68.

Treatment of Triple Fracture of the Superior Shoulder Suspensory Complex

• Jung CY
• Eun IS
• Kim JW
• Ko YC
• Kim YJ
• Kim CK

• KMID: 2106574
• DOI: http://doi.org/10.4055/jkoa.2011.46.1.68

Abstract

The Superior Shoulder Suspensory Complex (SSSC) is a bony and soft tissue ring comprising the glenoid process, the coracoid process, the coracoclavicular ligaments, the distal clavicle, the acromioclavicular joint, and the acromion. The SSSC maintains a normal stable relationship between the upper extremity and the axial skeleton. High-energy injury, such as traffic accident or a fall, can cause disruption of the SSSC. Single traumatic disruption of the SSSC is common. However, double disruption of the SSSC is infrequent and surgical management is generally necessary. We have experienced a case of triple fracture involving the coracoid process, the acromion, and the distal end of the clavicle. Such disruption of the SSSC has not been previously reported in our country and only one case has been reported in the Western literature; the authors obtained positive clinical results with surgical treatment. We report here on this case and include a review of the relevant literature.

Keyword

shoulder; superior shoulder suspensory complex; triple fracture; operative treatment

MeSH Terms

Accidents, Traffic
Acromioclavicular Joint
Acromion
Clavicle
Ligaments
Shoulder
Skeleton
Upper Extremity

Figure

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  Figure 1 The preoperative anteroposterior view (A) and lateral view (B) images show triple fracture involving the proximal portion of coracoid process, acromion and distal end of clavicle.

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  Figure 2 The preoperative 3D-CT images. Anterior view (A) and superior view (B) images show fracture of proximal portion of coracoid process, distal end of clavicle and acromion.

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  Figure 3 Postoperative radiographs. Anterior (A) and lateral (B) views after open reduction and internal fixation show callus formation around fracture sites.

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  Figure 4 Radiographs taken 8 months after surgery show good union after removal of screw and K-wires.

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  Figure 5 Superior shoulder suspensory complex (SSSC) is a bony and soft tissue ring comprising the clavicle-acromionclavicular joint-acromion strut (A), clavicle-coracoclavicular ligament-coracoid linkage (B), and three process-scapular body junction (C).

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