The term floating shoulder was used in 1992 by Herscovici et al to describe their series of ipsilateral fractures of the clavicle and scapular neck.
Although some have questioned the accuracy of this definition, the term floating shoulder, in contemporary use, usually refers to ipsilateral fractures of the clavicle and scapular neck but can also apply to any combined injury to the superior shoulder suspensory complex (SSSC).
Floating shoulder injuries are rare. They result from high-energy trauma and have a high incidence of associated injuries, which likely contribute to their underdiagnosis and undertreatment. Understanding the pathologic anatomy and instituting appropriate treatment are important for minimizing the sometimes significant morbidity from this injury.
Although this unstable injury tends to have a better outcome in patients in whom the clavicle fracture is surgically stabilized (particularly more distal clavicle fractures), the injury should be assessed in the context of the whole patient. Consideration of the age, demands, associated injuries, and the severity and displacement of the fracture may make nonoperative treatment preferable, with an expectation of a good result.