Quadruple Disruption of the Superior Shoulder Suspensory Complex: A Case Report on Surgical Intervention Following High-Energy Trauma in a Professional Cycling Athlete.

The superior shoulder suspensory complex (SSSC), which consists of several anatomical structures, plays a crucial role in stabilizing the shoulder girdle. While single disruptions can often be managed non-operatively, double disruptions typically require surgical intervention due to increased risks of complications like persisting instability, malunion, and/or non-union. In addition, quadruple disruptions are extremely rare and usually caused by high-energy trauma. Surgical repair is required to optimize functional outcomes. We present the case of a 34-year-old male professional cyclist who sustained a quadruple disruption of the SSSC after a high-speed fall. Computed tomography (CT) imaging revealed fractures of the distal clavicle, acromion, coracoid, and glenoid. In addition, the rider sustained an olecranon fracture. Given the high likelihood of persistent instability with non-surgical treatment, surgical fixation of the distal clavicle, acromion, and coracoid was performed, alongside olecranon stabilization. Postoperatively, the patient regained full function within three months and returned to competitive cycling. This case illustrates the rare occurrence of quadruple disruptions of the SSSC following high-energy trauma and the need for surgical intervention. The patient achieved excellent functional outcomes. This highlights the importance of timely surgical intervention to prevent complications and support full recovery.