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Bone pathologies involving the shoulder girdle are common and the rehabilitation is most frequently achieved through conservative treatments. We present the case of 20-year-old female patient with multiple trauma due to high-energy accident. Among the injuries, there was a displaced fracture of the diaphysis of the right clavicle, a displaced fracture of the left humerus, 11 fractures in 8 ribs (2 with displacement) and scapular dyskinesis. Considering the instability of the thorax and the incompatibility between the fixation "8" (Watson-Jones) and the disposition of the displaced fragments, we designed a fracture immobilizer based on the functional analogy of the shoulder girdle. The external traction system developed emulates the action of the Pectoralis Major, Deltoid, Trapezius, Latissimus Dorsi, the upper area of the Oblique of the Abdomen and Serratus Anterior. The continuous use of the product during six weeks allowed the consolidation of the fractures, restored the stability of the scapular girdle and the range of functional movement. The adequate traction of the fragments of the clavicle and its slight overlap contributed to attenuate the discontinuity in the shoulder. The main achievements in the proposed design are: double traction effect; posterior fixation to keep the clavicle and shoulder blades in position under dynamic conditions and the possibility of applying pressure in a gradual and independent way in predetermined points. These principles could be applicable in the rehabilitation of other types of multiple fractures.

Fundamentos biomecánicos en el diseño de inmovilizador para rehabilitación de fracturas múltiples