Bipolar clavicle injury: posterior dislocation of the acromioclavicular joint with anterior dislocation of the sternoclavicular joint: A report of two cases

Bipolar dislocation of the clavicle

“…However, with the promising result brought about by the use of the Kirschner wires, reported by Echo6 and Benabdallah,7 more and more surgeons became interested in open surgical treatment which was characterized by simultaneous treatment at the two related joints 211. The following studies also proved that strong fixation not only ensures earlier rehabilitative training but also prevents deformity secondary to redislocation 89. Nevertheless, it could also cause unpredictable intra and postoperative complications.…”

“…In contrast to low-energy trauma like falling,34 bike riding,5 undoubtedly, a high-impact collision is considered the most common reason for bipolar clavicle dislocation 26–9. Two hypotheses have been suggested as the mechanism of the synchronous dislocation of both the joints.…”

“…Therefore, more reliable internal fixation is required in the case of sternoclavicular joint dislocation. Schemitsch et al .,9 had used Balser plate instead of Kirschner wires to fix the dislocation of sternoclavicular joint and achieved success, proving that the selection of implant material is the key to the therapy of bipolar dislocation. But in our opinion, T-plate is superior to other inter-fixation materials due to the following three reasons: Firstly, though is in a smaller size, it is stronger; secondly, it has high plasticity; and finally, it resembles skeleton owing to its elasticity modulus.…”

A rare case of floating clavicle and a novel technique for stabilizing the sternoclavicular joint

“…In all of the cases reported so far, the dislocation is anterior at the SCJ and posterior at the ACJ. 4 The mechanism of injury in the bipolar dislocation of the clavicle is complex, resulting from a violent blow to the lateral aspect of the shoulder or a heavy compression with an associated torsion of the trunk. 16,17 Biomechanical studies have shown that the force required to dislocate the SCJ posteriorly is 50% higher than the force needed for anterior dislocation.…”

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

“…This requires an extensive surgical approach. [1415] However, functional results do not differ considerably in those cases and implant removal is usually necessary in all described techniques.…”