Extra-Articular Fracture of the Medial End of the Clavicle Associated With Type Iv Acromioclavicular Dislocation: Caae Report

Abstract

Fractures of the clavicle and acromioclavicular dislocations are very common injuries when they occur separately. The combination of an acromioclavicular dislocation and a fracture of the lateral third of the clavicle is not rare. However, there are very few reported cases of acromioclavicular dislocations associated with fractures of the middle third of the clavicle; those associated with fractures of the medial third are even rarer. We report the case of an adult male who suffered an acromioclavicular dislocation (type IV) associated with a displaced extra-articular fracture of the medial end of the clavicle (Almann group 3) in a cycling accident. The patient was treated during the acute phase with open reduction and internal fixation of the two lesions. At the clinical evaluation 12 months after the surgery, the patient was asymptomatic, with full active and passive mobility, and normal strength and endurance of the shoulder girdle. Radiographs and a three-dimensional CT scan showed persistent posterosuperior subluxation of the acromioclavicular joint and anatomical consolidation of the clavicular fracture.

Surgical treatment for fracture of the medial end of the clavicle associated with ipsilateral acromioclavicular dislocation

“…Association of ACJ dislocation and medial third fracture are extremely rare [ [1] , [2] , [3] ] and so, only a few cases have been reported in the literature. To our knowledge, this is the first case reporting diagnosis and treatment of a stage IV ACJ dislocation associated to a medial end clavicle fracture.…”

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

“…Multiple surgical techniques have been published, including management with temporary Kirschner wires, reconstruction plate osteosynthesis [ 16 ], hook-plate for the distal clavicle or ACJ dislocation [ 10 ], multiple interfragmentary screw synthesis for the proximal clavicle [ 17 ], anatomical or non-anatomical joint reconstruction with sutures [ 8 ], allo- or autologal ligament graft [ 11 ], and transosseous button systems as the one described in this case. Since good results have been reported with all of these techniques, we argue that it is advisable to use the one in which the surgeon is most experienced.…”

A novel surgical method for treating medial‑end clavicle fractures

“…They treated 10 medial-end clavicle fractures and all patients gained osseous healing without complications. Correa et al (15) showed that using a reconstruction plate to treat medial-end clavicle fractures made it possible to obtain satisfactory clinical effects. Sidhu et al, Ding et al and Sloan et al used clavicular hook plates and contralateral lateral clavicle locking plates to treat medial-end clavicle fractures (4,16,17).…”