Scapulothoracic dissociation, as manifested by lateral displacement of
the scapula and acromioclavicular separation, is a previously unreported
injury in which there is a complete disruption of the scapulothoracic
articulation without an overlying partial or complete amputation through
the soft tissue. Associated with the disruption of the scapulothoracic
articulation are injuries to the brachial plexus and the subclavian artery
and vein; multiple open and closed fractures of the ipsilateral upper
extremity are often present also. In the patient with severe multiple
injuries, scapulothoracic dissociation may not be recognized immediately,
with potentially fatal consequences. In this paper we present the cases of
three patients with radiographic and pathological evidence of
scapulothoracic dissociation and review the literature on related
injuries.