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REFERENCE LINKING PLATFORM OF KOREA S&T JOURNALS
> Journal Vol & Issue
Clinics in Shoulder and Elbow
Journal Basic Information
Journal DOI :
Korean Shoulder and Elbow Society
Editor in Chief :
Volume & Issues
Volume 8, Issue 2 - Dec 2005
Volume 8, Issue 1 - Jun 2005
Selecting the target year
Rotator Cuff Tear: Decision Making
Lee Yong-Geol ;
Clinics in Shoulder and Elbow, volume 8, issue 2, 2005, Pages 57~62
DOI : 10.5397/CiSE.2005.8.2.057
Osteochondritis Dissecans of Elbow Joint
Oh Jeong-Hwan ; Choi Jin-Hyung ; Park Jin-Young ;
Clinics in Shoulder and Elbow, volume 8, issue 2, 2005, Pages 63~67
DOI : 10.5397/CiSE.2005.8.2.063
Osteochondritis dissecans is a common cause of lateral elbow pain in throwing athletes and gymnasts between the age of 10 and 15 years. The pain frequently is insidious and progressive in nature and is relieved with rest in most cases. Compressive forces at the radiocapitellar joint along with a tenuous blood supply to the region may play a role in the etiology of this condition. Treatment is directed according to presenting symptoms, radiographic findings and status of the involved segment. Surgical management involves either an excision of a loose lesion and removal of loose bodies or reattachment of an osteochondral fragment. The role of subchondral penetration of debridement of the defect after fragment excision is unclear. Whether to excise and debride or to fix an unstale fragment is a highly controversial topic. The clinician should recognize osteochondritis dissecans of the elbow as a potentially disabling condition where the prognosis for return to sport is guarded
주관절 불안정성 (Elbow Instability)
Lee Seok-Beom ;
Clinics in Shoulder and Elbow, volume 8, issue 2, 2005, Pages 68~74
DOI : 10.5397/CiSE.2005.8.2.068
Kim Pung-Taek ; Jeon In-Ho ;
Clinics in Shoulder and Elbow, volume 8, issue 2, 2005, Pages 75~80
DOI : 10.5397/CiSE.2005.8.2.075
Chung Sun-Gun ;
Clinics in Shoulder and Elbow, volume 8, issue 2, 2005, Pages 81~87
DOI : 10.5397/CiSE.2005.8.2.081
Epicondylitis, as a tendinopathy characterized by fibroblast and microvascular hyperplasia, is a common musculoskeletal problem especially related with repetitive hand and wrist motion. It has a prevalence of between 0.2% and 5% in general population depending on the amount of exposure to manual labor jobs. Although it is known that the pathological lesions lie in the flexor or extensor common tendons, there could be collateral ligament lesions and/or reactive synovitis accompanied, which may make a case unresponsive to the treatment aimed only at the tendinopathy. Epicondylitis is easy to diagnose with typical pain, tenderness, and positive provocation tests. However, many conditions can mimic epicondylitis that further imaging or electrodiagnostic studies should be undertaken to exclude other possible problems. Ultrasonography provides information about the existence and extent of tendinopathy with relatively high specificity. Magnetic resonance imaging is often required to rule out other problems and confirm the diagnosis of the cases intractable to long term treatment. Many options of treatment are available for epicondylitis while numerous conflicting evidences have been noted, debating one treatment method is better than the others. Since it was reported that over 80% of epicondylitis improved within a year no matter what was done as treatment, it is a challenge to make accurate diagnosis and combine effective therapeutic regimens for the 20% of intractable cases.
The Surgical Treatment in Type III Acromioclavicular Dislocation Patients Over 45 Years - Primary Clavicular Lateral End Resection Method vs. Conventional Acromioclavicular Joint Reduction Method -
Moon Eun-Sun ; Bae Bong-Hyun ; Choi Jin ; Kim Myung-Sun ;
Clinics in Shoulder and Elbow, volume 8, issue 2, 2005, Pages 88~96
DOI : 10.5397/CiSE.2005.8.2.088
Purpose: To compare and analyze the outcome of primary clavicular lateral end resection method and conventional acromioclavicular (AC) joint reduction method in type III AC dislocation patients over 45 years. Materials and Methods: This study was performed on selected 24 cases of type III AC dislocation patients, over 45 years of age, operated at our hospital from 1998 to 2002. Group I consist of 12 patients who underwent primary clavicular lateral end resection methods (average age: 54.3 years
). Group II consist of 7 patients using Bosworth methods and 5 patients using Phemister methods (average age: 54.4 years
). Clinical outcome was evaluated by Weaver and Dunn method. Radiological results were compared by measuring coracoclavicular distance between normal and injured side. Results: As clinical outcome, good was 10 cases(83%); fair 2(17%) in Group I, and good 6(50%); fair 3(25%); poor 3(25%) in Group II. In contrast, the difference of coracoclavicular distance was not statistically significant between two groups before or after surgery, and last follow up. At the last follow up, there was no special correlation between the difference of coracoclavicular distance and clinical outcome. Conclusion: We considered that primary clavicular lateral end resection may be effective for prevention of arthrosis in AC joint in type III AC dislocation patients over 45 years.
The Results of Surgical Treatment of Comminuted Fractures of Distal humerus
Cho Nam-Su ; Park Sung-Woo ; Jung Ki-Yoen ; Rhee Yong-Girl ;
Clinics in Shoulder and Elbow, volume 8, issue 2, 2005, Pages 97~104
DOI : 10.5397/CiSE.2005.8.2.097
Purpose: To report the results of surgical treatment of comminuted fractures of distal humerus and to identify factors that affect the results. Materials and Methods: Thirty-two patients who were treated with open reduction and internal fixation for comminuted fracture of distal humerus were enrolled. According to the AO classification, A2.3 was 1 case, A3.2, 2 cases, A3.3, 8 cases, B1.3, 1 case, B2.3, 1 case, C2.2, 5 cases, C2.3, 4 cases, C3.2, 3 cases and C3.3, 7 cases. As fixation technique, 17 cases were fixed by double plates, 4 cases by only K-wires, 4 cases by only screws, 3 cases by K-wires and screws and 4 cases by one plate and screws. The mean age at the time of the operation was 49 years(range,
years). The mean follow-up period was 16 months(range,
months). Results: At the last follow-up, the mean maximum flexion was
and the mean loss of terminal extension was
. The average Mayo elbow performance score was
. Overall 29 cases(91%) showed good to excellent results. The mean range of motion of extraarticular and intraarticular fracture group was
, respectively. The average elbow score of both groups was
. Over 90% showed more than good results. 30 cases(94%) showed complete bony union but two cases, nonunion. One case of the nonunion cases underwent replating with bone graft as revision surgery and total elbow arthroplasty was performed in the other case. At the last follow-up, 27 patients(84.4%) showed subjective satisfaction. Conclusion: Open reduction and internal fixation with appropriate surgical technique for comminuted fractures of distal humerus showed good results, which were not affected by age at the time of operation, fixation methods and anterior transposition of the ulnar nerve. Transolecranon approach may be considered as good choice for intraarticular comminuted fractures of distal humerus.
Analysis of Exit Site of Guide Pin Using Tansglenoid Suture Technique in Bankart and SLAP Lesion
Rhee Kwang-Jin ; Shin Hyun-Dae ; Byun Ki-Yong ; Kim Young-Mo ; Joo Yong-Bum ; Kim Kyung-Cheon ;
Clinics in Shoulder and Elbow, volume 8, issue 2, 2005, Pages 105~109
DOI : 10.5397/CiSE.2005.8.2.105
Purpose: To Analyze the exit site of pin inserted at the anterior glenoid rim in the reconstruction of the Bankart lesion and SLAP lesion using transglenoid suture technique. Materials and Methods: In the twenty adult right cadeveric scapula, insertions of pin were performed using guide at the position of 1, 2, 3 O'clock of glenoid rim. We measured the exit site of dorsal surface of the scapula by medial distance from sagittal plane of lateral border of scapular spine and the vertical distance from posterior border of the scapular spine. Results: When the pin was inserted caudally within 10 degree, at the position of 1, 2, 3 O'clock, the medial distance from lateral border of the scapula is averaged 29.4, 19.2, 34.0 mm respectively and the vertical distance from posterior border of the scapular spine is averaged 15.0, 18.6, 17.2 mm respectively. When the pin was inserted caudally within 20-30 degree, the medial distance is averaged 14.6, 14.2, 15.8 mm respectively and the vertical distance is averaged 31.6, 31.9, 32.1 mm respectively. Conclusion: When the pin was inserted caudally within ten degrees using the guide, the pin exit appeared at the more medial side of the base of scapular spine and the more inferior of scapular spine. This can make the firm suture tied over scapular spine during repair SLAP and the Bankart lesion, and also prevent the injury of suprascapular nerve.
MRI of Acute Septic Arthritis of the Shoulder Joint; Correlation with Arthroscopic Findings
Seo Kyung-Jin ; Cheon Sang-Ho ; Seo Jae-Sung ; Ko Sang-Hun ; Choi Chang-Hyuk ; Jeon In-Ho ;
Clinics in Shoulder and Elbow, volume 8, issue 2, 2005, Pages 110~116
DOI : 10.5397/CiSE.2005.8.2.110
Purpose: Urgent diagnosis and treatment of the septic arthritis is required. The purpose of this study is to review to correlate preoperative MRI findings with arthroscopic findings in septic arthritis of the glenohumeral joint. Materials and Methods: Eleven patients with acute septic arthritis of the glenohumeral joint were treated with combination of arthroscopic lavage, debridement, and systemic antibiotics. The arthroscopic staging of infection was made based on the modified criteria of
and five major findings of MRI were marked in each stage of septic shoulder. Results: Bone and cartilage erosion was the end stage finding and two patients with all five positive findings had failed with arthroscopic treatment. Reactive bone marrow edema was evident in the greater tuberosity. Joint effusion, synovial thickening and soft tissue edema were rather non-specific finding and presented in all stages of septic shoulder. Conclusion: Diffuse marrow edema with metaphyseal cyst formation in the preoperative MRI implied advanced stage of septic arthritis, which may fail with arthroscopic debridement.
The Hallym Slider: A New Arthroscopic Simple Sliding and One-Way Locking Knot
Noh Kyu-Cheol ; Chung Yung-Khee ;
Clinics in Shoulder and Elbow, volume 8, issue 2, 2005, Pages 117~121
DOI : 10.5397/CiSE.2005.8.2.117
A secure slip knot is very important in the arthroscopic surgery of the shoulder joint. The new 'Hallym Slider', developed by the first author(KCN), has the properties of being a simple sliding and one-way locking knot. This technique can be performed alone without an assistant and has no accidental premature locking during the knot tying. The initial slip knot determines the adequacy of tissue approximation and consequent healing. The 'Hallym Slider' has excellent initial holding capacity, maintaining tension on soft tissue while additional half-hitches are being tied. It locks readily, it takes less time to tie than numerous square knots, and it is not as bulky as other knots. Therefore, we introduce this new sliding and one-way locking knot during the arthroscpic surgery of shoulder.
A Long-term Results of Ulnohumeral Arthroplasy in Primary Osteoarthritis of the Elbow
Shin Sung-Ryong ; Kim Hyung-Nyun ; Park Yong-Wook ; Lee Sang-Soo ; Jeong Un-Seob ; Kim Do-Young ;
Clinics in Shoulder and Elbow, volume 8, issue 2, 2005, Pages 122~126
DOI : 10.5397/CiSE.2005.8.2.122
Purpose: To assess the long-term effect of ulnohumeral arthroplasty and the relationship between radiological recurrence and clinical outcome. Materials and Methods: Eleven elbows with primary osteoarthritis were analyzed at an average of eighty months after ulnohumeral arthroplasty. All patients were male with a mean age of fifty years. The outcomes were assessed using the Mayo Elbow Performance Score(MEPS) and the clinical and radiological results were compared. Results: Four elbows were not painful and six were mildly painful but one was not changed. The mean gain in extension was
, in flexion
. There were satisfactory results in 8 elbows(73%) and the mean MEPS was 81 points. All of eleven elbows had some degree of recurrent osteoarthritis and there was no correlation between radiological recurrence and clinical endpoints in nine elbows. But in two elbows, it appeared that recurrence of osteophyte at coronoid process was severe and caused fair outcome. Conclusion: Ulnohumeral arthroplasy is one of the effective treatment options for primary osteoarthritis of the elbow. The radiological recurrence did not correlated with the clinical outcome in most cases.
SP Knot: A New Arthroscopic Sliding Flip Knot With A Lag Bight
Yoon Kang-Sup ; Lee Ji-Ho ; Kang Seung-Baik ; Lee Jae-Hyup ; Lee Myung-Chul ; Jo Hyun-Chul ;
Clinics in Shoulder and Elbow, volume 8, issue 2, 2005, Pages 127~130
DOI : 10.5397/CiSE.2005.8.2.127
We describe a secure and easy-to-tie knot with a lag bight, the SP knot. An optimal sliding knot is required to be a low-profile, easy to throw, slide well, and provide a good initial security. The SP knot easily slides and sets while avoiding premature locking during sliding. While maintaining tension on the post limb with a knot pusher, pulling the loop limb makes it to flip and distort post limb, resulting in creation of a snug knot on the exact location with desired tension. The SP knot has one knot configuration before pulling the loop limb, but it converts to two knots after pulling the loop limb, one half-hitch and one 'clove hitch', which could provide enough loop security before any additional half-hitches. The configuration of the completed SP knot is formed lying along the loop of the knot, rather than stacking up, which enables a very low profile. The SP knot has various characteristics of the optimal arthroscopic slip knot and may be a useful tool for successful arthroscopic surgery.
Distal Clavicle Tunnel Widening after Coracoclavicular Ligament Reconstruction with Semitendinous Tendon: A Case Report
Yoo Jae-Chul ; Kim Seung-Yun ; Lim Tae-Gang ; Jeong Ju-Seon ; Song Baek-Yong ;
Clinics in Shoulder and Elbow, volume 8, issue 2, 2005, Pages 131~134
DOI : 10.5397/CiSE.2005.8.2.131
Distal clavicle tunnel widening was observed in coracoclavicular ligament reconstruction with semitendinous tendon autografts in a patient with acromioclavicular joint injury. Acromioclavicular joint separation, in a 44 years-old man was treated by coracoclavicular ligament reconstruction. We have performed x-ray evaluation on 2years 10months after surgery. The immediate postoperative tunnel size was measured 4.5mm in diameter. At postoperative 2years 10month the tunnel diameter was from 9.3 to 11.4mm. But the weightbearing clavicle view showed no significant acromioclavicular joint separation. Moreover the patient complained only minor intermittent shoulder discomfort.
Surgical Treatment of the Acute Acromioclavicular Joint Dislocation with a LIGASTIC Artificial Ligament
Choi Sun-Jin ; Kim Sang-Hyo ; Park Han-Sung ;
Clinics in Shoulder and Elbow, volume 8, issue 2, 2005, Pages 135~140
DOI : 10.5397/CiSE.2005.8.2.135
Purpose: To find out the early results after surgical treatment of the acute acromioclavicular dislocation with LIGASTIC artificial ligament. Material and Method: 6 patients who were diagnosed as acute acomioclavicular joint dislocation and treated with LIGASTIC artifical ligament through March 2005 to July 2005. The radiologic and clinical results using Imatani evaluation system were analyzed. Results: By clinical evaluation, 4 cases(67%) were excellent and 2 cases(33%) were good. By radiologic evaluation, 3 cases(50%) were excellent and 3 cases(50%) were good. All cases showed satisfactory results. Till the final follow up, there were no complication. Conclusion: Surgical treatment of the acute acromioclavicular dislocation with LIGASTIC articifial ligament is simple, but provides enough stability for early postoperative rehabilitation, decreases arthritis of acomioclavicular joint and there is no burden of removal of the fixture, so it is thought as a very effective surgery.
Continuous intra-lesional Infusion Combined with Interscalene Block for Effective Postoperative Analgesia after Arthroscopic Shoulder Surgery
Oh Joo-Han ; Kim Jae-Yoon ; Gong Hyun-Sik ; Kim Jae-Kwang ; Kim Sang-Gee ; Kim Tae-Yune ; Rhee Ka-Young ; Kim Woo-Sung ;
Clinics in Shoulder and Elbow, volume 8, issue 2, 2005, Pages 141~147
DOI : 10.5397/CiSE.2005.8.2.141
Purpose: The purpose of this study was to compare the effectiveness of postoperative pain control by intravenous patient-controlled analgesia (IV) to the effectiveness of postoperative pain control by continuous intra-lesional infusion of local anesthetics (IL) with or without an interscalene brachial plexus block (ISB) after arthroscopic shoulder surgery. Materials and Methods: We designed this prospective randomized case-controlled double-blind study, and allocated 84 consecutive patients to four groups according to postoperative analgesic method, i.e., Group IV, Group ISBIV, Group IL, and Group ISB-IL after arthroscopic shoulder surgery. Postoperative pain, side effects and supplemental analgesics were recorded at 1 hour and then at every 8 hours for 2 days. Result: The demographic and clinical characteristics of four groups were identical statistically. Interscalene block (Group ISB-IV, Group ISB-IL) was found to be effective at relieving pain and at reducing supplemental analgesic amounts at 1 and 8 hours postoperatively (p<0.05). Patients in the Group ISB-IL had less pain at 16 and 48 hours postoperatively than the other groups (p<0.05). Continuous intra-lesional infusion (Group IL, Group ISB-IL) was superior in reducing analgesic-related side effects (p<0.05). Conclusion: This study suggests that a combination of an interscalene brachial plexus block and continuous intralesional infusion of ropivacaine is an effective and safe method of postoperative pain control in patients after arthroscopic shoulder surgery.
Initial and Recurrent Anterior Dislocation in Shoulder
Kim Young-Kyu ; Lee Jae-Hoon ; Kim Hyun-Min ; Lee Choong-Hoon ;
Clinics in Shoulder and Elbow, volume 8, issue 2, 2005, Pages 148~153
DOI : 10.5397/CiSE.2005.8.2.148
Purpose: To assess the usefulness of early stabilization for initial shoulder dislocation which is indicated in some patients by comparing the arthroscopic findings and the outcomes of Bankart repair in the initial and recurrent dislocation. Materials and Methods: The study was performed on 16 cases of initial dislocation and 44 cases of recurrent dislocation. The follow-up period was 25 months in the initial dislocation group and 28 months in the recurrent group. Bankart lesion and the adjacent tissues were compared, and the results were evaluated by the Rowe rating scale. Results: Detached labrum and capsular ligament of the initial dislocation group were elastic and unretracted. While in the recurrent dislocation those were inelastic, and displaced and adhesive in many cases. The outcomes were mean 95 points in the initial group and 91 points in the recurrent group. In the initial group, apprehension was detected in only 1 case(6%). In the recurrent group, instability was detected in 4 cases(9%). Conclusion: Our data suggest that Bankart lesion in the initial dislocation can be repaired readily by surgery, the recovery is efficient, and the recurrence would be reduced. Thus, in active young sports lovers as well as athletes, early stabilization surgery for initial shoulder dislocation may be more helpful.
Elastofibroma Dorsi as a Cause of Snapping Scapula - A Case Report -
Hwang In-Hwan ; Kim Jong-Woo ; Oh Sung-Kyun ; Park Hyung-Bin ;
Clinics in Shoulder and Elbow, volume 8, issue 2, 2005, Pages 154~157
DOI : 10.5397/CiSE.2005.8.2.154
Elastofibroma dorsi is a benign soft tissue mass, not well-known because of its low incidence, and usually located between the chest wall and the inferomedial aspect of the scapula. This lesion is not true neoplasm but rather reactive hyperplasia of elastic fibers. It is mostly nontender mass, but occasionally causes snapping symptom. This tumor should be considered as a differential diagnosis of snapping scapula. The clinical diagnosis is made by magnetic resonance imaging and confirmed by pathologic findings. We present a case report of a female with elastofibroma dorsi, who had that the chief complaint was snapping scapula and palpable mass. We emphasize that snapping lesions located deep beneath the inferior tip of the scapula on the chest wall should arouse suspicion of an elastofibroma dorsi.
Usefulness of Arthroscopy on Treatment of Double disruption of Superior Shoulder Suspensory Complex - Two cases including Fracture of Glenoid -
Kim Bo-Hyun ; Kang Shin-Taek ; Park Ill-Seok ; Byun Jae-Yong ;
Clinics in Shoulder and Elbow, volume 8, issue 2, 2005, Pages 158~165
DOI : 10.5397/CiSE.2005.8.2.158
The Superior Shoulder Suspensory complex (SSSC) maintains a normal stable relationship between the upper extremity and the axial skeleton. Traumatic double disruptions of the SSSC frequently create an unstable anatomic situation and is difficult-to-treat. When this double disruption is managed conservatively, significant displacement can occur at either or both sites and result in long-term problems and functional disabilities. Therefore surgical management is generally necessary. The authors experienced two cases of double disruptions of the SSSC treated with arthroscopic surgery & and reported good results.
Periosteal chondroma of the proximal humerus - A case report -
Ahn B.W. ; Jung S.W. ; Kim B.H. ; Cho J.I. ; Wang K.T. ; Kim W.S. ; Kim C.K. ;
Clinics in Shoulder and Elbow, volume 8, issue 2, 2005, Pages 166~169
DOI : 10.5397/CiSE.2005.8.2.166
Periosteal chondroma is a slow growing benign chondroid tumor. It erode the surface of cortex and induce a saucer shape defect. Histologically, it occasionally show hypercellularity, mitosis which can lead to the erroneous diagnosis of malignant tumor. Clinical, radiographic and pathological investigations are necessary to establish the diagnosis. Marginal excision proved an effective treatment. To our knowledge, this benign chondroid tumor of humerus has never been previously reported in Korea. We report a case of periosteal chondroma of proximal humerus mimicking periosteal chondrosarcoma.
Bilateral Painful Snapping Scapula - A Case Report -
Shin Sung-Ryong ; Ko Young-Seok ; Park Yong-Wook ; Lee Sang-Soo ; Jeong Un-Seob ; Kim Do-Young ;
Clinics in Shoulder and Elbow, volume 8, issue 2, 2005, Pages 170~175
DOI : 10.5397/CiSE.2005.8.2.170
Painful and disabling snapping scapula is an unusual condition and there have been several reports that have revealed good results after surgical treatment for unilateral snapping scapula. We experienced a case of bilateral painful snapping scapula in a young man, but with successful treatment by partial resection of the superomedial angle of both scapula. Preoperative 3-dimensional CT revealed bony prominence of the superomedial angle of both scapula and narrowing between superior scapular angle and chest wall.
Acute Ulnar Nerve Palsy after Outerbridge-Kashiwagi Procedure - A Case Report -
Jeon In-Ho ; Min Woo-Kie ; Oh Chang-Wug ; Hwang In-Hwan ; Kim Poong-Taek ;
Clinics in Shoulder and Elbow, volume 8, issue 2, 2005, Pages 176~180
DOI : 10.5397/CiSE.2005.8.2.176
The Outerbridge-Kashiwagi (O-K) procedure is one of popular procedures for the treatment of osteoarthritis of the elbow. Although reliable outcome has been reported in the literature, intraoperative and postoperative complications may occur. Acute postoperative neurologic complications are rarely reported in the literature. We report a case of acute complete ulnar neuropathy following O-K procedure in the elbow with longstanding flexion loss. Prophylactic ulnar nerve decompression during the O-K procedure should be considered in the elbows with osteoarthritis and prolonged severe flexion contracture.
Simple Anterior Dislocation of the Elbow - Case Report
Lee Bong-Jin ; Lee Sung-Rak ; Kim Seong-Tae ;
Clinics in Shoulder and Elbow, volume 8, issue 2, 2005, Pages 181~186
DOI : 10.5397/CiSE.2005.8.2.181
An anterior dislocation of the elbow without a fracture of the olecranon is an extremely rare injury. This paper reports a 36-year-old male who stumbled and fell on his outstretched hand during a soccer game. The anteroposterior and lateral radiographs indicated a simple anterior dislocation of the elbow, which was reduced using a closed method. The elbow joint was stable in the range of motion, but the sensation of the two ulnar digits was still reduced. MRI was useful for the identification of the pathoanatomy. At the follow-up examination three months after the initial trauma, the hypesthesia has fully recovered and the patient regained the full range of the elbow and forearm motion without pain and instability. After 18 months, the patient had a normal elbow function, and could play various sports. If an anterior elbow dislocation is detected early, a closed reduction with careful pathoanatomical considerations would be successful.
Open Scapulothoracic Dissociation - Case report -
Seo Sung-Woo ; Jung Hyo-Sub ; Moon Jun-Gyu ;
Clinics in Shoulder and Elbow, volume 8, issue 2, 2005, Pages 187~191
DOI : 10.5397/CiSE.2005.8.2.187
Traumatic scapulothoracic dissocation is a rare upper extremity injury caused by massive traction or blunt trauma. Most cases are associated with a large spectrum of concomitant injuries, including severe musculoskeletal injuries and neurovascular injuries around the shoulder. But, it occurs without damaging overlying skin as a closed injury rather than an open injury. We present a case of open scapulothoracic dissociation and describe clinical features with literature review.