Traumatic Floating Clavicle: A Case Report

Teixidor-Serra, Jordi; Tomás, Jordi; Batalla, Lledó; Pedemonte, Jordi; Pacha, Daniel; Molero, Vicente; Carrera, Lluís

doi:10.1097/bot.0b013e318205e215

Cited by 9 publications

(4 citation statements)

References 6 publications

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“…The first reported case of a floating clavicle, also termed bipolar clavicle injury, or panclavicle injury, dates from late XVII th century [ 3 ]. A little over 40 cases have been published ever since, most of them being single-case reports [ 3 , [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] ]. This entails a paucity of therapeutic guidelines to aid in decision-making and makes this injury easy to overlook in the ER.…”

Section: Discussionmentioning

confidence: 99%

Floating clavicle after a high velocity biking accident: A case report of an acromioclavicular dislocation with simultaneous proximal clavicle fracture managed surgically

Moreno-Fenoll

Valencia

Fahandezh-Saddi

et al. 2021

International Journal of Surgery Case Reports

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Introduction Clavicle fractures and acromioclavicular joint dislocations are very common injuries. However, the combination of both, known as “floating clavicle” is extremely rare, with approximately 40 cases reported. Presentation of case We report a case of a healthy 51-year-old male who suffered a high-velocity biking accident, with a bipolar clavicle injury (type IV acromioclavicular joint dislocation and proximal clavicle fracture), with concomitant rib fractures and pulmonary contusion. He received early surgical treatment by open reduction and osteosynthesis of the proximal clavicle (distal ulna plate, Protean ®) and open reduction and stabilization with a MINAR ® implant for the acromioclavicular joint. After an initial one-month immobilization, he started physical therapy. In the 10-month follow-up he presented with a pain-free full range of motion, a good cosmetic result, and radiological consolidation. Discussion Bipolar clavicle injury is a rare clinical entity that encompasses a spectrum of combined clavicle fractures, acromioclavicular or sternoclavicular joint dislocations. They are sustained in a high-energy context, and accompanying injuries must be sought. Diagnosis is made through X-Ray and CT. Despite the lack of clinical guidelines, most authors agree on surgical management of at least one of the injuries, with multiple surgical techniques available. There is an emphasis in surgical treatment of the young and active patient. Conservative treatment is associated with poorer results. Conclusion It is advisable to have a high index of suspicion for floating clavicle in a high-energy trauma patient, given possible life-threatening injuries, and long-term shoulder sequelae. Surgery should be considered in a young and active patient.

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Section: Discussionmentioning

confidence: 99%

Floating clavicle after a high velocity biking accident: A case report of an acromioclavicular dislocation with simultaneous proximal clavicle fracture managed surgically

Moreno-Fenoll

Valencia

Fahandezh-Saddi

et al. 2021

International Journal of Surgery Case Reports

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“…Because the lever arm was shorter in patients with posterior SCJ dislocation than in those with anterior SCJ dislocation, the authors stated that a greater force was needed to cause bipolar dislocation in those with posterior SCJ dislocation than in those with anterior SCJ dislocation, and it was more likely to be accompanied by a proximal clavicle fracture at the intersection with the first rib. Some patients have a medial clavicle fracture at the intersection of the first rib and ipsilateral ACJ dislocation [ 5 , 26 – 28 ]. Even though it cannot account for the mechanism of all bipolar dislocations, we think that the “first rib pivot theory” can be used to explain the characteristics of bipolar dislocation as well as the occurrence of another type of “floating clavicle” such as medial clavicle fracture with ACJ dislocation.…”

Section: Discussionmentioning

confidence: 99%

“…Bipolar dislocation of the clavicle is a rare injury that was first described in 1831 by Porral, and it is characterized as dislocation of both ends of the clavicle: the acromioclavicular joint (ACJ) and sternoclavicular joint (SCJ). This injury is also called “floating clavicle” [ 1 – 7 ], although this name is often used to describe any combinations of dislocation and fracture at both ends of the clavicle [ 2 , 5 ]. In 1924, Beckman published a case report with a review of 15 previously reported patients with this injury, but no other cases were reported until the early 1980s.…”

Section: Introductionmentioning

confidence: 99%

Bipolar Dislocation of the Clavicle: A Report of Two Cases with Different Injury Patterns and a Literature Review

Okano

Sawada

Inagaki

2017

Case Reports in Orthopedics

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Bipolar dislocation of the clavicle is a rare injury that is defined as a concomitant dislocation of the ipsilateral acromioclavicular joint and sternoclavicular joint. This injury is also described as a floating clavicle. Although this injury has been known for nearly two centuries, knowledge about it is limited and the treatment strategy remains controversial. Bipolar dislocation includes several combinations of both joints' injury types. We reported two patients with bipolar dislocation of the clavicle: one with an anterior dislocation and the other with a posterior dislocation of the sternoclavicular joint. After reviewing the currently available literature, we discussed these cases to highlight the necessity of a specific treatment approach that is modified based on the pattern of each joint's lesion.

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“…To the best of our knowledge, there are only two reports on a combination of a lateral and medial clavicle fracture in combination with SC joint dislocations. [23]…”

Section: Introductionmentioning

confidence: 99%

Combination of a floating clavicle and a posterior shoulder dislocation: An "Unhappy Triad" of the shoulder girdle

Schliemann

Theisen

Kösters

et al. 2014

Int J Shoulder Surg

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We present a case of a 31-year-old man who suffered from a floating clavicle in combination with a reverse Hill-Sachs lesion of his right shoulder girdle after a bicycle accident. Operative treatment was performed using minimal-invasive and arthroscopically assisted techniques.We strongly recommend an early CT scan with later 3-dimensional reconstruction to detect and fully understand these complex injuries.

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Traumatic Floating Clavicle: A Case Report

Cited by 9 publications

References 6 publications

Floating clavicle after a high velocity biking accident: A case report of an acromioclavicular dislocation with simultaneous proximal clavicle fracture managed surgically

Floating clavicle after a high velocity biking accident: A case report of an acromioclavicular dislocation with simultaneous proximal clavicle fracture managed surgically

Bipolar Dislocation of the Clavicle: A Report of Two Cases with Different Injury Patterns and a Literature Review

Combination of a floating clavicle and a posterior shoulder dislocation: An "Unhappy Triad" of the shoulder girdle

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