Shoulder Girdle Injuries

The shoulder girdle is a complex anatomical chain connecting the axial to the upper appendicular skeleton, including the sternoclavicular, acromioclavicular, and glenohumeral joint as well as the clavicle, scapula, and proximal humerus. Because of this complex which has multiple linkages which allow for multiplanar motion, the sequela of untreated shoulder injuries tends to be less devastating than their lower extremity counterparts. Whereas improved outcomes may result from successful operative treatment, nonoperative treatment can yield reasonable function in many cases, and thus the surgical risk analysis must be assessed carefully based on the hospital environment. The majority of shoulder girdle injuries in the austere environment can be managed nonoperatively with temporary immobilization followed by physical therapy. Operative indications and techniques are explained for the surgeon working in a limited resource setting. A shoulder girdle injury rehabilitation program is outlined at the end of the chapter.