Bilateral Clavicle Fractures: A Report of Three Cases

Abstract

We have encountered three cases of bilateral clavicle fractures with different modes of trauma in three different age groups. One of these patients had a high-velocity roadside accident while the other case suffered a crush injury between a wall and a tractor. In the third case, a motorcycle fell over the patient. All of the fractures united well after conservative treatment with the return of normal functional activity. With the increasing incidence of high-energy trauma, we may encounter more of these injuries in the future. Case 1A 6-year-old girl presented to our hospital with pain swelling and bony instability over both the midclavicular regions. She was unable to move both of her shoulder girdles due to pain. She fell off from a stationary motorcycle and then the motorcycle fell over her. The patient had a history of a short period of unconsciousness followed by one episode of vomiting. Her GCS score was to be normal when brought to the hospital after few hours of the injury. CT scan head was found normal. X-ray chest with bilateral shoulders revealed displaced mid-clavicle fractures on both the sides [ Bilateral clavicle fractures are uncommonly reported in the literature with the incidence being less than 0.5% of all the clavicle fractures. Bilateral clavicle fractures are caused either by high-energy transfer of compression forces across both shoulder girdles or by a direct trauma to one clavicle followed by that to the other clavicle. These fractures could be missed due to their association with more severe chest injuries or a more symptomatically displaced fracture on one side or due to inadequate chest radiographs. We report three cases of traumatic bilateral clavicle fractures with three modes of injuries in different age groups. All the fractures were treated conservatively with good functional outcomes without any sequelae. Bilateral clavicle fractures should be actively sought by every trauma team with proper clinical examination and chest radiographs including both shoulder joints in high-energy trauma cases or with bilateral shoulder compression injuries.her upper limbs. The trauma team managed the fractures with a figure-of-8 bandage with shoulder slings conservatively. The patient was observed for 24 hours for a minor head injury that she sustained and was discharged thereafter. She was reviewed in outdoor at 3 weeks, 6 weeks and 12 weeks respectively. Both clavicles united in acceptable positions with full, pain-free shoulder function bilaterally [Table/ Fig-2a,b]. Case 2A 25-year-old man was involved in a high-velocity road traffic accident when his bike skidded on a road divider. He complained of pain on the left upper chest wall and in the left clavicle region. On examination he was found to be hemodynamically stable. He sustained a blunt chest injury with tenderness and bruises over the left upper chest wall. He was found to have multiple rib fractures on the left side along with a left clavicle fracture [Table/ Fig-3a] on initial evaluation. The patient had no lung injuries and had a no...

Bilateral Clavicle Fractures - A Rare Injury

“…Bilateral clavicle fractures could be missed because of their association with more severe chest injuries or a more symptomatically displaced fracture on one side or due to inadequate chest radiographs. Lakhotia, et al reported in their case series that fractures with various energy mechanisms were treated conservatively and returned to good functional outcomes without any complications [ 3 ]. Kulkarni, et al demonstrated in their study that intramedullary K-wire fixation at a single setting on both clavicle fracture showed good bridging callus formation and the full range of motion without any disturbance of daily activities [ 4 ].…”

Double-plate fixation in double clavicle fractures: A case report

“…Although clavicle fractures represent 2–5% of all fractures in adults and accounting for > 10% in children [6] , [7] , bilateral clavicle fractures are rarely reported in the literature [8] , [9] . Most clavicle fractures have been managed non-surgically due to the high complication rates of the surgical treatment [10] .…”

Isolated bilateral clavicular fracture: A case report

“…2 Bilateral clavicle fractures are usually described in the setting of polytrauma and are often missed due to other concomitant life-threatening injuries that draw all the attention. 3 In high-energy trauma cases and bilateral shoulder compression injuries, proper clinical assessment and chest radiographs including both shoulder joints should be performed, and bilateral clavicle fractures should be actively sought. 3 There is no general consensus on the modality of treatment of bilateral clavicle fracture.…”