Rehabilitation of a patient with ‘floating shoulder’ and associated fractures: A case report

Abstract

Study design: Case report. Background: Scapular fractures are uncommon, and displaced glenoid fractures are even rarer. Surgery is usually performed for severely displaced fractures and positive outcomes have been reported, although some patients have residual limitations. Published rehabilitation guidelines are limited. The purpose of this case report is to describe the physical therapy (PT) rehabilitation of a patient with a complicated scapular fracture, and to describe factors influencing his outcome. Case description: Exercise, manual therapy, and modalities were used in the rehabilitation process. Outcome measures included manual muscle testing for strength, goniometry for range of motion (ROM), and the shoulder pain and disability index (SPADI) for function. Outcomes: Improvements in strength, ROM, and function were noted. The patient had full ROM, 4 + /5 to 5/5 strength, and a SPADI score of 3/100 at discharge from PT. Discussion: The patient achieved a favorable outcome, in spite of having a long-duration wound infection and a second surgery for hardware removal. Further research should identify the optimal rehabilitation progression for patients with this type of surgery.