Medial fractures are the least common type of clavicular fracture (2-10%). The patient is a 29-year-old gynaecology resident with hyper-laxity and sternoclavicular instability. The latter had been surgically stabilized with Dacron 1 tape, which eroded the bone causing an usura. Acute right shoulder pain occurred 10 years later. CT revealed medial clavicular stress fracture. After 4 weeks of conservative management, internal fixation followed. Five months postoperatively the patient performed all activities without pain. In this patient the weakened medial clavicle due to usura clearly played a role in both the site and nature of the fracture. Furthermore, CT is essential in arriving at the correct diagnosis.
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