An Unusual Case Of Segmental Clavicle Fracture

Abstract

Fracture of the clavicle is a common traumatic injury and comprises 4% of all fractures in adults. Amongst these, midshaft injuries account for the majority and medial fractures are uncommon (1). Whilst segmental fractures have been reported in the literature, concurrent lateral and medial injuries are very rare. These injuries are, therefore, susceptible to being missed, due to failure to look for a second injury after the initial diagnosis, and difficult X-ray interpretation around the area of the medial clavicle. The nature of segmental fractures can pose a difficult management problem for numerous reasons, and initial operative fixation is usually indicated. Early diagnosis is therefore imperative, and as such, clinical examination is essential even if an obvious mid or lateral shaft fracture is seen on X-ray. This unusual case of combined lateral and medial fractures was initially missed and the presentation and management is discussed.

Displaced Fractures of the Medial End of the Clavicle: Report of Five Cases

“…Franklin 17 in 1897 described a segmental fracture of the medial and middle parts of the clavicle caused by a collision between a bicycle and a horse. Segmental fractures of the medial and lateral ends of the clavicle were only found in one other published report, 18 and on inspection of those radiographs, the fractures of the medial clavicle were located more laterally than in our case.…”

Temporary Sternoclavicular Plating for an Unusual Double Clavicle Fracture (Medial Nonunion, Lateral Acute) Complicated by an Intraoperative Pneumothorax

“…The rationale for doing this was (1) the reported difficulty in obtaining enough screw purchase into the small medial clavicle fragment [12, 16–18] and (2) our initial impression that our patient might be noncompliant with lifting and shoulder motion restrictions, which could lead to nonunion if rigid fixation was not employed. Also, the only other reports that we could locate at that time that described sternoclavicular plating (for fracture or sternoclavicular dislocation) used a hook plate [16, 19], which is designed for a lateral clavicle fracture [20]. We were concerned a hook plate would not provide sufficient rigidity for our patient.…”

The Different Treatment Methods for Segmental Fractures of the Clavicle: Cases Report

“…Some reports described that this type fracture occur due to two separate concurrent forces. 3) One is direct force on the point of the shoulder girdle due to fall. The other is an indirect force, which may give rise to clavicle fractures by the shearing force delivered from the humerus to the sternum.…”