Traumatic Floating Clavicle: Is This a Rare Injury?

Abstract

Bipolar clavicle dislocation is thought to be a rare injury pattern. Even experienced orthopaedic surgeons may have not come across this entity during their careers. We report a misdiagnosed case of a 65-year-old male who underwent a motorcycle accident and was surgically treated six months post-injury. This case has been the ground for research since then. We have come to the conclusion that this type of injury is probably not so uncommon as previously thought. Careful evaluation is of immense importance during diagnosis protocol, and practitioners should be aware of this injury pattern in order to avoid misdiagnosis.

Can Only Fix Sternoclavicular Joint to Treat Bipolar Clavicle Injury?

“…For most oating clavicle, the medial end displaced anteriorly while the lateral end displaced superiorly or posteriorly (Rockwood type III or IV). Eni-Olotu and Hobbs [7] reported a case of inferior displacement of lateral end and superior displacement of the medial end. And, only a few of bipolar clavicle injury with posterior SC joint dislocation have been found [4,8,22,23].…”

“…When the external force disappears, the clavicle relaxes and returns to its normal shape, the energy continues to conduct on both sides of the clavicle, causing each clavicle end ligaments damage and subsequent dislocation of the acromioclavicular joint and sternoclavicular joint [7,19]. And the another one proposes that an initial dislocation of the sternoclavicular joint followed by subsequent dislocation of the acromioclavicular joint [20].…”

“…Owing to the rarity and limited experience of this injury, treatment remains controversial and challenging. In the early stage, most authors treated their patients nonoperatively with satisfactory results [2,3,7,20,24]. However, most patients sustained deformity residual pain or instability [20].…”

“…Bipolar injury of the clavicle is rare and often caused by high-energy trauma, although road-tra c and sports injuries have increased the frequency of clavicle injury, most reports have been based on single cases, only a few of published English studies presented multiple cases [4][5][6][7][8]. Thus, treatment of this injury remains limited.…”

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

“…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.…”