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What is Superior Shoulder Suspensory Complex (SSSC)?

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Superior Shoulder Suspensory Complex (SSSC) is a bony soft tissue ring at the end of a superior (middle 1/3 clavicle) and an inferior (scapular body/glenoid neck junction) bony strut. It is composed of:
  1. Glenoid process
  2. Coracoid process
  3. Coraco-clavicular (CC) ligament
  4. Distal clavicle
  5. Acromio-clavicular joint (ACJ)
  6. Acromion process

Pasapula C, Mandalia V, Aslam N. The floating shoulder. Acta Orthop Belg. 2004 Oct;70(5):393-400. PMID: 15587025.

The complex can be subdivided into 3 subunits:
  1. Clavicular - ACJ - Acromial strut
  2. Three processes - scapular body junction
  3. Clavicular - CC ligamentous - coracoid linkage (C4)
This complex maintains a normal stable relationship between the scapula and the axial skeleton. 

Single traumatic disruptions of SSSC are common and anatomically stable. Nonoperative treatment generally yields a good result.

Double disruption leads to SSSC disruption and anatomically unstable situation. e.g., Floating shoulder (mid-clavicular fracture + glenoid neck fracture).

Reference: Rockwood and Matsen's The Shoulder E-Book edited by Frederick A. Matsen, Frank A. Cordasco, John W Sperling, Steven B. Lippitt