The floating shoulder: classification criteria, treatment indications, and functional outcomes
Abstract
The floating shoulder is a complex injury in which the superior shoulder suspensory complex (SSSC) is disrupted at two or more points, typically through fractures of the clavicle and scapular neck. Its management remains debated, particularly the choice between surgical and conservative treatment. This narrative review summarizes selected recent evidence (2020–2026), supplemented by classic background references, on: (1) classification criteria and radiographic parameters used for severity stratification; (2) indications for surgical versus conservative management; (3) functional outcomes. A non-systematic search of PubMed and Scopus was performed, and five core studies were discussed: two systematic reviews, one prospective case series, one case report and one cadaveric biomechanical study. The radiographic parameters most commonly used to guide treatment are the glenopolar angle (GPA), glenoid medialization and clavicular shortening. The thresholds applied, however, derive largely from earlier studies of scapular and clavicular fractures, and their prognostic value in floating shoulder injuries remains to be established. Satisfactory functional outcomes have been reported after both conservative and surgical management. Injuries with significant scapular neck displacement may benefit from combined fixation, while minimally displaced injuries appear to do well with conservative treatment or clavicle fixation alone. The available evidence is of low level, and prospective multicenter studies are needed to define optimal treatment thresholds.
Affiliations
License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Copyright
© © Ortopedici Traumatologi Ospedalieri d’Italia (O.T.O.D.i.) , 2026
How to Cite
- Abstract viewed - 8 times
- PDF downloaded - 1 times