Floating shoulder" may be considered to be an unstable displaced fracture of the surgical or anatomical neck of the scapula with or without a clavicular fracture. In cases of surgical neck fractures, there must occur an associated rupture of the coracoclavicular and coracoacromial ligaments or a fracture of their osseous equivalents (acromion and extra-articular or intra-articular coracoid base).
Injury to the superior shoulder suspensory complex without a fracture of the anatomical or surgical neck does not result in floating shoulder. If isolated, these superior shoulder suspensory complex lesions are mostly stable, and their displacement is minimal.
Radiographs are inadequate to determine the exact fracture pattern for fractures of the surgical neck and body of the scapula. Therefore, examination should include 3-dimensional computed tomographic reconstructions, in standardized views, with subtraction of the surrounding bones.
Unstable displaced fractures of the surgical or anatomical neck of the scapula should undergo a surgical procedure via the Judet approach.