Ipsilateral Rockwood type V acromioclavicular joint dislocation and midshaft clavicle fracture: A case report.

World J Orthop

Department of Orthopedic Surgery, King Saud Medical City, Riyadh 00966, Saudi Arabia.

Published: December 2024

AI Article Synopsis

  • Clavicle fractures are common in emergency departments, while acromioclavicular (AC) joint injuries are rare and even more so when combined with clavicle fractures.
  • A 29-year-old male patient experienced both an AC joint dislocation and a midshaft clavicle fracture, leading to surgical treatment that resulted in excellent recovery and range of motion after one year.
  • The case highlights the rarity of this combination of injuries and stresses the importance of timely diagnosis and investigation to achieve favorable functional outcomes, although there's still no agreement on the best treatment approach.

Article Abstract

Background: Clavicle fractures are among the most common fractures seen in the emergency department. While acromioclavicular (AC) joint injuries are much less common. However, ipsilateral combinations of these injuries are quite rare with only a few cases reported in the literature.

Case Summary: A 29-year-old man who sustained a combination of ipsilateral AC joint dislocation and midshaft clavicle fracture. He underwent open reduction and plate fixation of the clavicle fracture, as well as semi-rigid surgical implants used to restore both the AC ligaments and the coracoclavicular joint. one year follow-up revealed that the patient had a complete range of motion and excellent shoulder scores. This case presents a rare presentation of such combination of injuries, contributing valuable insights to the literature on such rare injuries.

Conclusion: Combined midshaft clavicle fractures and AC joint dislocations are considered quite rare. Timely diagnosis of such injuries leads to great functional outcomes. AC joint dislocation should be suspected with midshaft clavicle fractures and should be investigated radiologically and clinically in an appropriate manner. Still, there is no consensus on the optimal management of such injuries.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11686529PMC
http://dx.doi.org/10.5312/wjo.v15.i12.1208DOI Listing

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Article Synopsis
  • Clavicle fractures are common in emergency departments, while acromioclavicular (AC) joint injuries are rare and even more so when combined with clavicle fractures.
  • A 29-year-old male patient experienced both an AC joint dislocation and a midshaft clavicle fracture, leading to surgical treatment that resulted in excellent recovery and range of motion after one year.
  • The case highlights the rarity of this combination of injuries and stresses the importance of timely diagnosis and investigation to achieve favorable functional outcomes, although there's still no agreement on the best treatment approach.
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In this report, we present a case of a triple clavicle injury, acromioclavicular joint (ACJ) dislocation, a middle third clavicle fracture, and a sternoclavicular joint (SCJ) subluxation, and describe its successful surgical treatment. A 49-year-old female patient sustained a 3 m fall, resulting in direct trauma to her left shoulder. Initial radiographs and computed tomography (CT) scans revealed a displaced middle third clavicle fracture, a high-grade ACJ dislocation, and a posterior SCJ subluxation.

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Introduction: Clavicle fractures are routinely encountered in orthopedic clinical practice and have often been the subject of debate when it comes to optimal treatment. Clavicle fracture surgery has come a long way with excellent pre-contoured superior locking plates available for fixation. This study aimed to evaluate a cohort of patients operated for displaced mid-shaft clavicle fractures by open reduction and internal fixation using superior clavicle locking plates.

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Purpose: Although open reduction and internal fixation (ORIF) is the gold standard treatment for displaced midshaft clavicle fractures, recent studies have advocated for nonoperative management, citing high rates of reoperation associated with operative intervention. However, no studies have compared nonoperative management to ORIF with dual-plate fixation, which may be associated with lower rates of reoperation compared to single-plate fixation. The purpose of this study was to compare the complications and patient-reported outcomes of dual mini-fragment plate fixation to nonoperative management for displaced midshaft clavicle fractures.

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Background: The realities of midshaft clavicle fracture distribution have not been described accurately. Consequently, a topographical depiction of midshaft clavicle fractures may help design implants that are more anatomically concordant with the fractured clavicle, leading to better outcomes and fewer complications.

Methods: This is a retrospective cohort study.

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