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• W2034697060 abstract "Open fractures of the shoulder are extremely rare, and their treatment is a major challenge for surgeons. Only cases encountered in military settings have been reported thus far. Such fractures are often the result of ballistic trauma, which causes extensive damage to both bony and soft tissues. Since these injuries are associated with a high risk of infection and the presence of comminuted fractures, external fixation is necessary for repair. Use of external fixators and revascularization techniques has reduced the number of cases requiring shoulder amputation or disarticulation. Injury to the proximal extremity of the humerus, acromion, and clavicle further complicates the treatment. No published studies have described the assembly of external fixators for fractures in the scapular region with significant bone loss. In addition, no cases have been described in civilian settings. However, with an increase in urban violence and the traffic of illegal arms, civilian surgeons are now encountering an increasing number of patients with these injuries. In this report, we not only present a rare case of floating shoulder injury in a civilian setting but also provide an overview of the existing treatment strategies for this type of trauma, with special focus on the use of external fixators in elective shoulder arthrodesis and on military cases. Les fractures ouvertes de l’épaule sont extrêmement rares. Leur prise en charge est un véritable challenge thérapeutique pour le chirurgien. Les seuls cas décrits dans la littérature sont ceux de chirurgiens militaires. En effet, les plaies balistiques sont à l’origine de délabrement majeur au niveau de l’os et des parties molles. Le risque septique et la comminution des fractures imposent la fixation externe. L’utilisation du fixateur externe et les techniques de revascularisation ont permis de limiter le taux d’amputation et de désarticulation de l’épaule. L’atteinte ipsilatérale de l’extrémité proximale de l’humérus, de l’acromion et de la clavicule rend la prise en charge complexe. On ne trouve pas d’articles dans la littérature décrivant le montage du fixateur dans la région scapulaire quand une perte osseuse importante existe. Aucun cas n’a été décrit au sein d’un hôpital civil ; cependant avec la montée des violences urbaines et le trafic des armes illégales, nous sommes amenés en tant que chirurgiens civils à rencontrer ce type de lésion. Nous avons voulu, à l’aide de ce cas rare, décrire des stratégies de prise en charge adaptées à ce type de traumatisme, en nous appuyant sur l’expérience de la fixation externe dans les arthrodèses scapulo-humérales programmées (paralysie du plexus brachial, arthrites, etc.) et sur les séries rapportées dans les journaux militaires." @default.
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• W2034697060 date "2014-10-01" @default.
• W2034697060 modified "2023-09-26" @default.
• W2034697060 title "PreFix™ external fixator used to treat a floating shoulder injury caused by gunshot wound" @default.
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• W2034697060 doi "https://doi.org/10.1016/j.main.2014.07.002" @default.
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