A pseudo-iatrogenic case of medial clavicular fracture

Abstract

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.

Hook plate for medial clavicle fracture

“…Some authors have advocated additional views or even conventional tomography 7. It is now generally agreed that CT is the examination of choice, not only to precisely define the type of fracture and dislocation but also to reveal any associated injury of adjacent structures 8. In our case, CT scan elucidated the combination of a medial clavicle fracture with posterior fracture dislocation.…”

Joint reconstruction using sternocleidomastoid tendon autograft as a treatment for traumatic posterior dislocation of sternoclavicular joint: A case report

“…However, the incorporation of additional views, such as the “serendipity” view and the use of conventional CT scans, had been suggested [ 5 ]. It is now generally agreed that CT scans are the optimal imaging modality, not only to precisely determine the type of fracture and dislocation but also to reveal any associated injury to adjacent structures [ 6 ]. In the current case, the patient was evaluated by CT with 3D reconstruction which clearly demonstrated the direction and severity of the displacement.…”