Traumatic Shoulder Girdle Injury: Relation to the Mechanism of Trauma, and the Age and Sex of Patients

Abstract

Fractures and dislocations are common manifestations of shoulder girdle injuries (SGI) and are routinely diagnosed using radiography. SGI were investigated in relation to age and sex, and trauma. Furthermore, the number of diagnostic errors arising from evaluating SGI without the use of imaging tools was investigated. Two consultant radiologists retrospectively analyzed 572 shoulder radiographs from 293 patients for evidence of fractures and dislocations. The age and sex of patients, radiographic indications, etiology, clinical diagnoses, and cadres of the requesting physicians and the reporting radiologist were also recorded. Eighty-seven shoulder fractures were diagnosed and 44.4% were accounted for by road traffic injuries (RTI). Scapular fractures occurred predominantly in males aged 20-39 years (P = 0.031) after high-energy trauma, and the majority were associated with other shoulder girdle and extra-shoulder fractures. Falls and RTI accounted for 50% and 61.5% of fractures in patients less than 20 years of age and aged between 20-39 years, respectively (P=0.001). Clinical evaluation of SGI without using imaging tools resulted in 52 of 72 patients (72.2%) being diagnosed incorrectly. Falls are a common cause of SGI in females aged less than 10 years, and scapular fractures are more common than previously thought. This study demonstrates that radiography is invaluable for the evaluation and diagnosis of SGI