Abstract:Although clavicle fractures are common, fracture dislocations of the medial end are rare. We report on a case of a 17-year-old patient who presented with a fracture of the medial clavicle with an associated anterior dislocation of the sternoclavicular joint. The patient underwent successful surgical management resulting in fracture union, restoration of shoulder stability and full functional range of motion at latest follow-up.
“…Hence the use of CT has become the gold standard whenever there is doubt regarding the diagnosis. In addition, CT can give information to discern true SCJ dislocation from a physeal injury in younger patients with an open physis [2,18,19]. The patients' age and previous radiation exposure must be considered when using this modality.…”
“…Hence the use of CT has become the gold standard whenever there is doubt regarding the diagnosis. In addition, CT can give information to discern true SCJ dislocation from a physeal injury in younger patients with an open physis [2,18,19]. The patients' age and previous radiation exposure must be considered when using this modality.…”
“…To date, four case reports of concomitant anterior SC joint dislocation and ipsilateral midshaft fracture of the clavicle have been reported in the literature in which all cases were treated surgically. [1][2][3][4] The SC joint shows a low congruency and is mainly stabilized by the surrounding ligaments and posterior capsule. [8,9] Conservative treatment of isolated SC joint dislocations shows redislocation up to 100%.…”
Section: Discussionmentioning
confidence: 99%
“…[14] Concurrent sternoclavicular (SC) joint dislocation and ipsilateral clavicle fracture is a very rare injury with only few cases reported in the literature. [1][2][3][4] Even isolated SC dislocations are rare injuries and account for only 3% of all dislocations around the shoulder. [5] Anterior SC joint dislocations occur nine times more often than posterior SC joint dislocations.…”
mentioning
confidence: 99%
“…[18] To the best of our knowledge, there are only four case reports on simultaneous anterior SC joint dislocation and ipsilateral midshaft clavicle fracture reported in the literature over the last 30 years. [1][2][3][4] Herein, we present the surgical treatment of anterior SC dislocation associated with a midshaft clavicle fracture which was treated successfully.…”
A combination of an anterior sternoclavicular (SC) joint dislocation with a midshaft clavicle fracture is an extremely rare injury. If left untreated, it can lead to severely impaired function of the shoulder with a high risk for complications. A 45-year-old male patient presented with pain and impaired range of motion (ROM) in the left shoulder after a mountain bike crash. Radiographs and a computed tomography scan showed an anterior dislocation of the left SC joint and an ipsilateral midshaft fracture of the clavicle. Open reduction and internal fixation (ORIF) of the clavicle combined with SC joint stabilization using transosseous sutures was performed. Postoperatively, a shoulder-arm bandage was applied with passive motion starting on the first postoperative day. During follow-up, the patient showed an improved clinical function and could return to work after three weeks. Radiographs at eight weeks showed fracture healing without any signs of recurrent SC dislocation. At the final follow-up at 12 weeks, the patient returned to his pre-injury activity level and recreational sports. Despite minimal redislocation in the SC joint, the Constant-Murley Score showed a continuous improvement with 93%, compared to the contralateral side. In conclusion, surgical treatment of anterior SC joint dislocation with a midshaft clavicle fracture can restore shoulder function with no surgery-associated complications.
“…Although rare, such injuries require rapid diagnosis followed by effective treatment to avoid future complications [8]. Specifically, periarticular and intraarticular fractures remain a therapeutic challenge: The medial fragment is too small to stabilize with common linear implants, and bending forces that occur during shoulder motion are disproportionately high [9].…”
The medial clavicle fracture is a rare injury and almost all the times conservatively treated. Therefore, the number of operations reported in the literature are limited. Posterior dislocation can result in serious complications and such injuries require rapid diagnosis followed by effective treatment to avoid future complications. The present case reports a case of a 33-year-old healthy man that was involved in a high-fall, being diagnosed with a rare displaced medial clavicular fracture associated with an unstable posterior lateral fragment dislocation surgically treated. Imagiological images and intraoperative photographs are presented. The authors collected this case in order to report this rare and complex injury. The treatment chosen to manage seems to give a good functional and radiographic recovery.
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