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BMJ Case Rep 2018 Jul 30;2018. Epub 2018 Jul 30.

Emergency Department, University of Plymouth, Plymouth, UK.

A 40-year-old woman presented to the emergency department with a painful left shoulder following a fall from a mountain bike. A radiograph of the clavicle and shoulder was carried out. A diagnosis of fractured left clavicle was made, which was treated conservatively in a sling. Read More

Orthopedics 2018 Sep 27;41(5):e681-e688. Epub 2018 Jul 27.

Eleven patients with bipolar clavicle injuries, including dislocation of both ends of the clavicle, dislocation of the sternoclavicular joint with distal clavicle fracture, dislocation of the acromioclavicular joint with medial clavicle fracture, and segmental fracture of the clavicle, were retrospectively reviewed. The purpose of this study was to report the clinical outcomes and a literature review of bipolar clavicle injury. Nonoperative treatment was performed for 5 patients and surgical treatment for 6 patients. Read More

Am J Case Rep 2018 Mar 21;19:325-328. Epub 2018 Mar 21.

Américo Brasiliense State Hospital, São Paulo, SP, Brazil.

BACKGROUND Kirschner wires are often used to perform osteosynthesis. Migration through tissue of these wires is a rare but well-known occurrence. CASE REPORT A 65-year-old female presented with light intensity pain complaints in the upper left chest area; personal history included left clavicle fracture 20 years ago that was treated surgically with fixation using a K-wire. Read More

J Shoulder Elbow Surg 2018 Apr;27(4):667-673

Department of Orthopaedic Surgery, University of Minnesota/Regions Hospital, St Paul, MN, USA. Electronic address:

Background: The purposes of this study were (1) to determine how supine versus upright patient position affects the measurement of diaphyseal clavicle fracture displacement, (2) to describe the incidence of progressive displacement in the peri-injury period, and (3) to investigate variables associated with the progressive displacement.

Methods: Between 2013 and 2015, patients aged 14 years or older presenting with a diaphyseal clavicle fracture within 7 days of injury were included (N = 50). A well-defined radiographic protocol was established. Read More

Orthop Clin North Am 2018 Apr 14;49(2):195-210. Epub 2017 Dec 14.

Department of Orthopaedic Surgery, Texas Scottish Rite Hospital for Children, 2222 Welborn Street, Dallas, TX 75219, USA. Electronic address:

The management of pediatric fractures has evolved over the past several decades, and many injuries that were previously being managed nonoperatively are now being treated surgically. The American Academy of Orthopaedic Surgeons has developed clinical guidelines to help guide decision making and streamline patient care for certain injuries, but many topics remain controversial. This article analyzes the evidence regarding management of 5 of the most common and controversial injuries in pediatric orthopedics today. Read More

J Shoulder Elbow Surg 2018 Jun 4;27(6S):S70-S75. Epub 2018 Jan 4.

Kerlan-Jobe Orthopaedic Clinic, Los Angeles, CA, USA.

Background: A large number of surgical techniques have been described to treat acromioclavicular (AC) joint separations. Despite the high success rates with double-tunnel reconstruction, this method has been associated with the risk of coracoid and clavicle fractures. This study aimed to evaluate the outcomes of the first cohort of patients who underwent single-tunnel AC and coracoclavicular (CC) ligament reconstruction. Read More

Medicine (Baltimore) 2017 Nov;96(46):e8781

aPediatric Orthopedic and Rehabilitation Department bDepartment of Interventional Radiology and Neuroradiology, Medical University of Lublin, Poland.

Rationale: Fracture of the clavicle is a very common injury in children. However, association between clavicle fracture and atlantoaxial rotatory displacement is rarely observed.

Patient Concerns: We present a case of an 8-year-old girl, who suffered a right clavicle fracture as a result of a sledge accident. Read More

Injury 2017 Nov;48 Suppl 5:S27-S33

Department of Trauma & Orthopaedics, General Hospital Karlovac, Croatia.

Introduction: The aim of this study was to present a modified Murray and Schwarz 2.5-mm Kirschner wire (K-wire) intramedullary (IM) technique for fixation of displaced midshaft clavicle fractures (DMCF), and to compare the differences in treatment outcome of two-part (Robinson 2B.1) and multifragmentary (Robinson 2B. Read More

Emerg Med J 2017 Nov;34(11):740

Department of Family Medicine and Denver Health Medical Center, University of Colorado Denver School of Medicine, Denver, Colorado, USA.

Clinical Introduction: A 74-year-old woman was brought to the ski clinic shortly after a fall on her left shoulder while skiing. She did not remember the exact fall mechanism. She felt a popping sensation in her left shoulder and was unable to move her left arm due to severe pain. Read More

J Int Med Res 2018 Jan 31;46(1):511-521. Epub 2017 Aug 31.

4 Department of Orthopedic Surgery, Shanghai Jiao Tong University affiliated Sixth People's Hospital, Shanghai, China.

Objective To investigate the role of acromioclavicular joint morphology in the presence of subacromial erosion after hook plate fixation. Methods We retrospectively analyzed the clinical data of 36 patients (17 men, 19 women; mean age, 48.7 years; range, 21-76 years) treated with hook plate fixation for distal clavicular fractures (n = 20) or acromioclavicular joint dislocation (n = 16) from August 2011 to March 2013. Read More

Radiography (Lond) 2017 Aug 22;23(3):e68-e71. Epub 2017 Mar 22.

Canterbury Christ Church University, School of Allied Health Professionals, North Holmes Road, Canterbury, CT1 1QU, United Kingdom.

Background: Acromioclavicular joint dislocation can be more complex than it first appears. The presented case had an unusual combination of injuries to the superior shoulder suspensory complex, which yielded some interesting learning points.

Case Summary: The injuries were sustained after a fall from a push bike and included acromioclavicular dislocation with coracoid process, clavicle and acromion process fractures. Read More

J Orthop Trauma 2017 Sep;31(9):468-471

*Department of Orthopedic Surgery, University of South Florida, Tampa, FL; †Geisinger Medical Center, Orthopaedic Institute, Danville, PA; ‡Orthopaedic Trauma Service, Florida Orthopaedic Institute, Tampa, FL; §Shoulder and Elbow Surgery Service, Florida Orthopaedic Institute, Tampa, FL; and ‖Department of Orthopaedics, Harborview Medical Center, Seattle, WA.

Objectives: To determine whether a difference in plate position for fixation of acute, displaced, midshaft clavicle fractures would affect the rate of secondary intervention.

Design: Retrospective Comparative Study.

Setting: Two academic Level 1 Regional Trauma Centers. Read More

Pediatr Emerg Care 2017 Jul;33(7):519-521

From the Department of Pediatrics, New York-Presbyterian Morgan Stanley Children's Hospital, Columbia University College of Physicians and Surgeons, New York, NY.

We report a case of an adolescent patient with medial clavicular tenderness after a fall on the lateral left shoulder. Initial radiographs did not reveal a fracture or dislocation. Point-of-care ultrasound was used to diagnose a posterior clavicular fracture dislocation. Read More

J Am Acad Orthop Surg 2017 May;25(5):339-347

From the Department of Orthopaedic Surgery, University of Texas Health Science Center, Houston, TX (Dr. Choo and Dr. Burgess), and the Department of Orthopaedics and Rehabilitation, University of Vermont Medical Center, Burlington, VT (Dr. Schottel).

Scapulothoracic dissociation is a rare, potentially limb- and life-threatening injury of the shoulder girdle. The injury is characterized by lateral displacement of the scapula resulting from traumatic disruption of the scapulothoracic articulation. The typical physical examination findings consist of substantial swelling of the shoulder girdle, along with weakness, numbness, and pulselessness in the ipsilateral upper extremity. Read More

Ugeskr Laeger 2017 Mar;179(10)

This is a case report of a 16-year-old boy with a bipolar fracture of the left clavicle. The patient crashed into a car on a moped with 40 mph. In the accident & emergency department (A&E) the patient was examined physically and by X-ray. Read More

J Orthop Surg (Hong Kong) 2017 01;25(1):2309499016684488

Taizhou Hospital of Zhejiang Province, Linhai, Zhejiang, China.

Purpose: Sternoclavicular joint is an amphiarthrodial joint formed by the clavicle and sternal manubrium. This joint becomes chronically unstable in case of a medial clavicle dislocation or fracture, and improper treatment could cause malformation and pain. We aimed to determine the efficacy of a novel sternoclavicular hook plate for treatment of unstable sternoclavicular joint dislocation or fracture. Read More

Pan Afr Med J 2016 22;25:19. Epub 2016 Sep 22.

Service d'Orthopédie-Traumatologie de l'Hôpital Général de Grand Yoff, Dakar, Sénégal.

This study aims to describe the epidemiological characteristics and the different anatomo-clinical entities of the fracture-separation of the medial clavicular epiphysis but also to relate the morphological and functional results of bloody reduction followed by osteosuture using non absorbable thread. Five boys and one girl (mean age 14 years) showed a closed and isolated shoulder girdle trauma. Clinical examination and medical imaging, especially CT scan, allowed the diagnosis of epiphyseal separation and to classify the degree of medial clavicular epiphysiseal ossification indicating the direction of displacement as well as the nature of displacement according to the Salter-Harris classification. Read More

Emerg Radiol 2017 Jun 26;24(3):281-286. Epub 2017 Jan 26.

Department of Trauma and Orthopedic Surgery 1; Westpfalz-Klinikum, Teaching Hospital of the Medical Faculty Mannheim, University of Heidelberg and of the University of Mainz, Hellmut-Hartert-Str.1, Kaiserslautern, Germany.

Purpose: Conventional radiography is frequently performed in pediatric patients in whom fractures and dislocations are suspected. However, until now, the rate of positive findings of the most commonly performed radiographic examinations in pediatric patients is unknown. The aim of this study was to evaluate the number of positive findings in the 20 most frequently requested standard radiographic examinations in pediatric patients in a level 1 trauma center systematically. Read More

Injury 2017 Feb 28;48(2):469-473. Epub 2016 Dec 28.

Department of Orthopaedic Trauma, Grant Medical Center, Columbus, OH, USA.

Introduction: Simultaneous ipsilateral clavicle and acromioclavicular (AC) joint injury have been infrequently reported in the literature at this time. The purpose of this study was to assess incidence as well as assess risk factors for this dual injury pattern.

Methods: We performed a retrospective review of a prospectively collected database (Level III evidence), evaluating 383 adult patients without previous shoulder girdle injury or trauma with a minimum 1-year follow-up who sustained a displaced diaphyseal clavicle fracture. Read More

J Shoulder Elbow Surg 2017 Apr 17;26(4):692-698. Epub 2016 Oct 17.

Department of Orthopaedic Surgery, Eulji Hospital, Eulji University School of Medicine, Seoul, Republic of Korea. Electronic address:

Background: This study was conducted to report loss of reduction and complications after single-tunnel coracoclavicular (CC) ligament reconstruction with autogenous semitendinosus tendon graft for acute acromioclavicular (AC) joint dislocations.

Methods: This retrospective study included patients with acute, unstable AC dislocations (surgery within 6 weeks after trauma). We excluded patients with chronic injury and distal clavicle fractures with CC ligaments disruption. Read More

Pediatr Emerg Care 2016 Oct;32(10):710-716

From the *Department of Neurological Surgery, Montefiore Medical Center/Albert Einstein School of Medicine, Bronx, NY; †Division of Neurosurgery, Duke University Medical Center, Durham, NC; and ‡Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, TX.

Pediatric emergency physicians must have a high clinical suspicion for atlantoaxial rotatory subluxation (AARS), particularly when a child presents with neck pain and an abnormal head posture without the ability to return to a neutral position. As shown in the neurosurgical literature, timely diagnosis and swift initiation of treatment have a greater chance of treatment success for the patient. However, timely treatment is complicated because torticollis can result from a variety of maladies, including: congenital abnormalities involving the C1-C2 joint or the surrounding supporting muscles and ligaments, central nervous system abnormalities, obstetric palsies from brachial plexus injuries, clavicle fractures, head and neck surgery, and infection. Read More

Am Fam Physician 2016 Jul;94(2):119-27

Rutgers University Robert Wood Johnson Medical School, New Brunswick, NJ, USA.

Acute shoulder injuries in adults are often initially managed by family physicians. Common acute shoulder injuries include acromioclavicular joint injuries, clavicle fractures, glenohumeral dislocations, proximal humerus fractures, and rotator cuff tears. Acromioclavicular joint injuries and clavicle fractures mostly occur in young adults as the result of a sports injury or direct trauma. Read More

Injury 2016 Oct 6;47(10):2235-2239. Epub 2016 Jun 6.

Department of Orthopaedic Surgery, Alfred Health, Melbourne, Victoria, Australia.

Background: Fractures of the medial third of the clavicle comprise less than 3% of all clavicle fractures. The natural history and optimal management of these rare injuries are unknown. The aim of our study is to describe the demographics, management and outcomes of patients with medial clavicle fractures treated at a Level 1 Trauma Centre. Read More

Clin Radiol 2016 Jul 23;71(7):702-9. Epub 2016 Apr 23.

Radiology Department, St Mary's Hospital, Imperial College Healthcare NHS Trust, Praed Street, London W2 1NY, UK.

Traumatic injuries involving the scapula and clavicle in skeletally immature patients have unique characteristics that distinguish them from similar injuries in the mature skeleton. Fractures involving unossified cartilage and unfused epiphyses are difficult to appreciate on plain radiographs and computed tomography (CT) imaging. Knowledge of the developmental anatomy and normal radiological appearances during different stages of development of these bones is an essential prerequisite for the radiologist tasked with interpreting the imaging of such injuries in order to avoid potential diagnostic pitfalls. Read More

Skeletal Radiol 2016 Aug 23;45(8):1123-7. Epub 2016 Apr 23.

Department of Orthopedic Surgery, University of Texas Health Science Center, 6400 Fannin Street; Suite 1700, Houston, TX, 77030, USA.

Sternoclavicular injuries are relatively rare, composing less than 1 % of all musculoskeletal fractures or dislocations. When sternoclavicular injuries do occur, they typically present as an isolated dislocation of the sternoclavicular joint without associated fracture of the clavicle or manubrium. However, in patients with unfused medial clavicle physis, sternoclavicular joint injuries can present as a fracture-dislocation through the unfused physis. Read More

J Orthop Trauma 2016 May;30(5):e181-5

Departments of Experimental and Clinical Medicine, and Orthopedic Surgery, Faculty of Health Science, Linköping University, Linköping, Sweden.

We describe a novel surgical technique for the treatment of displaced distal clavicular fractures in children. These fractures are rare, and recommendations on treatment vary. Conservative treatment might lead to persistent deformity and limitations of function. Read More

Instr Course Lect 2016 ;65:181-96

Orthopedic Surgeon, Blue Ridge Bone & Joint, Asheville, North Carolina.

The clavicle is the most frequently injured bone in the human body. In most cases, fractures that occur in the midshaft of the clavicle can be managed nonsurgically. An increasing number of studies suggest that displaced midshaft clavicle fractures have improved outcomes after surgical management, and equivalent outcomes can be achieved with both plating and intramedullary techniques. Read More

Arch Orthop Trauma Surg 2016 May 5;136(5):605-8. Epub 2016 Mar 5.

Department of Orthopaedic Surgery, Konyang University College of Medicine, 158 Gwanjeodong-ro, Seo-Gu, Daejeon, Republic of Korea.

Traumatic bilateral sternoclavicular joint dislocation is very rare injury. In shoulder girdle injuries, anterior dislocation of the sternoclavicular joint accounts for 3 % and posterior sternoclavicular joint dislocation is lesser. Previous reported cases about bilateral sternoclavicular joint dislocation were result from proximal clavicle fracture with intact connection between sternum and ribs. Read More

BMJ Case Rep 2015 Nov 23;2015. Epub 2015 Nov 23.

Department of Orthopaedics, Kasturba Medical College, Manipal, Karnataka, India.

A direct blow to the shoulder, as may be sustained in a road traffic accident (RTA), can result in various combinations of fracture dislocations in the shoulder joint complex. Among these, a rare variety is an acromioclavicular joint (ACJ) dislocation coupled with ipsilateral mid-shaft clavicle fracture. Diverse treatment options have been described in the literature, ranging from non-operative and operative, to hybrid management. Read More

Kurume Med J 2015 25;61(3-4):77-9. Epub 2015 Aug 25.

Department of Orthopaedic Surgery, Kurume University Medical Center.

Rupture of any two or more parts of the superior shoulder suspensory complex (SSSC) including the distal clavicle, acromion, coracoid process, glenoid cavity of the scapula, acromioclavicular ligament, and coracoclavicular ligament is associated with shoulder girdle instability and is an indication for surgery. Here we report a case of acromioclavicular joint dislocation associated with coracoid process fracture. A 48-year-old man sustained a hard blow to the left shoulder from a fall, and simple radiography detected a coracoid process fracture and acromioclavicular joint dislocation. Read More

Unfallchirurg 2015 May;118(5):427-31

Schulter- und Ellenbogenchirurgie, Klinik für Allgemeine, Unfall-, Hand- und Plastische Chirurgie - Campus Großhadern, Klinikum der Universität München (LMU), München, Deutschland.

Background: A 55-year-old male patient sustained a dislocation of the acromioclavicular (AC) joint in combination with a distal clavicle fracture.

Methods: Following closed reduction of the fractured clavicle, arthroscopically assisted coracoclavicular fixation was performed.

Discussion And Conclusion: A combined injury of a complete ac joint dislocation and a distal clavicle fracture is rare and is not included in currently available classification systems; therefore, in this article a classification and assessment of the stability of this injury as well as appropriate treatment options are discussed. Read More

Vojnosanit Pregl 2015 Feb;72(2):181-4

Introduction: Most scapular fractures are caused by high-impact blunt injuries, often as the result of motor vehicle accidents, fall from height, etc. In 80% to 90% of cases, scapula fractures are associated with multiple injuries (clavicle fracture, rib fractures, humeral fracture, pulmonary injury, brachial plexus injury).

Case Report: We presented scapular fracture in a 27-years-old male who had sustained a work-related injury when a ground soil brick machine pressed him. Read More

Radiologe 2015 Mar;55(3):188-94

CT- und MRT-Institut am Schillerpark, Rainerstr. 6-8, 4020, Linz/Donau, Österreich,

Background: Traumatic injuries to the shoulder joint occur both as isolated, especially to the humerus and clavicle, as well as accompanying glenohumeral dislocations.

Aim: To give an overview of the main approach of diagnostic imaging of the more common traumatic injuries to bone and/or cartilage of the shoulder joint. Only the scapula, proximal humerus and lateral clavicle are covered. Read More

Am J Orthop (Belle Mead NJ) 2014 Nov;43(11):E275-8

Department of Orthopaedics, West Virginia University, Morgantown, WV.

Acromioclavicular (AC) dislocation with an associated displaced fracture of the middle third of the clavicle is a rare injury with no established standard treatment. Previous AC fixation techniques described have not included simultaneous internal fixation of the clavicle. We present the case of a 19-year-old man who sustained this combined injury pattern with a type IV AC dislocation. Read More

Acta Chir Orthop Traumatol Cech 2014 ;81(2):118-21

Klinik und Poliklinik für Unfallchirurgie, Rechts der Isar, TUM, München, Germany.

INTRODUCTION While plate fixation remains the gold standard for surgical treatment for displaced mid-shaft clavicle fractures (DMCF), intramedullary fixation has emerged as a promising alternative. However, due to its more demanding technique and depending on the fracture's nature, an open reduction can be necessary. Aim of this study was to compare the outcome of open reduction versus closed reduction of DMCF using ESIN. Read More

Acta Chir Orthop Traumatol Cech 2014 ;81(3):238-40

Ortopedicko-traumatologické oddělení Nemocnice Mělník.

A rare case of a middle-third clavicle fracture concurrent with ipsilateral acromioclavicular dislocation in a 46-year-old women who had fallen off her bicycle is presented. The clavicular fracture was managed by locking plate osteosynthesis. The acromioclavicular joint was stabilised by traction osteorrhaphy that was removed at 7 weeks after the procedure. Read More

Lakartidningen 2014 May 14-20;111(20):879-82

BMJ Case Rep 2014 May 15;2014. Epub 2014 May 15.

Department of Trauma and Orthopaedics, Sunderland Royal Hospital, Sunderland, UK.

Many patients present to the emergency department complaining of a sore or stiff neck and lateral flexion of the neck with contralateral rotation. Under the pressure of the breaching time and busy shifts some of the patients are discharged to the care of their general practitioners without adequate investigations. While most of the cases are due to benign causes, torticollis can be due to many congenital and acquired pathologies, some of which may need further investigation and urgent management. Read More

Orthopedics 2014 Feb;37(2):e174-81

The management of sternoclavicular injuries in skeletally immature patients has not been well described. The purpose of this study was to describe the authors' experience treating this rare and potentially life-threatening injury. All skeletally immature patients who underwent treatment for a medial clavicular physeal fracture or sternoclavicular dislocation between 2003 and 2011 were identified using ICD-9 diagnostic codes. Read More

J Pediatr Orthop B 2014 Jul;23(4):375-8

Departments of aOrthopaedic Surgery and Traumatology bRadiology, Medicana International Istanbul Hospital, Istanbul, Turkey.

Retrosternal displacement of the medial clavicular metaphysis after a medial physeal fracture is a rare and potentially fatal injury because of possible damage of neurovascular structures, trachea and oesophagus. As the medial clavicular epiphysis does not ossify until 18-20 years of age and the medial clavicular physis is the last to close, around 22-25 years of age, this injury is difficult to demonstrate with plain radiographs in younger patients and is often mistaken for a sternoclavicular joint dislocation. We report on a 16-year-old boy with a fracture of the medial clavicular physis with retrosternal displacement of the metaphysis that was diagnosed with MRI, and discuss the diagnostic tools and treatment options in this rare injury. Read More

J Pediatr Orthop 2014 Jul-Aug;34(5):542-7

*Harvard Combined Orthopaedic Residency Program, Massachusetts General Hospital †Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, MA.

Background: Posterior sternoclavicular joint (SCJ) fracture dislocations in children and young adults can be missed on initial examination or could fail closed treatment. We hypothesize that surgical interventions (open reduction and ligamentous reconstruction or medial clavicle resection depending on the clinical scenario) are safe treatment options in patients with symptomatic chronic posteriorly displaced SCJ injuries.

Methods: A retrospective review was conducted of all patients younger than 25 years of age who underwent surgical treatment for chronic posteriorly displaced SCJ injuries at our institution from January 1, 1999 to December 31, 2011. Read More

Orthopade 2014 Mar;43(3):202-8

Centrum für Muskuloskeletale Chirurgie (CMSC) und Centrum für Sportwissenschaft und Sportmedizin (CSSB), Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland.

Background: During sports the shoulder complex is exposed to considerable load especially where throwing is important and various pathological changes can occur. In the last two decades the shoulder in athletes has become a special term in clinical sports medicine

Methods: Selective literature review in PubMed and consideration of personal experience, research results as well as national and international recommendations

Results: In general acute lesions of the shoulder caused by sudden sport injuries, such as traumatic luxation, acromioclavicular (AC) joint disruption, traumatic tendon ruptures, labral lesions, cartilage defects and fractures have to be distinguished from chronic or long-standing pathologies due to recurrent microtrauma, such as overuse bursitis and tendinitis, as well as secondary forms of impingement along with rotator cuff tears and labral lesions. Besides common pathological changes that can be observed in almost all overhead-sports, there are also injuries that are more sport-specific due to the particular load profile in each sport. Read More

J Orthop Surg Res 2014 Feb 6;9. Epub 2014 Feb 6.

Department of Orthopaedic Surgery, Wan Fang Hospital, Taipei Medical University, No, 111, Sec, 3, Xinglong Road, Taipei 11696, Taiwan.

Background: Clavicular hook plates are effective fixation devices for distal clavicle fractures and severe acromioclavicular joint dislocations. However, increasing number of studies has revealed that subacromial portion of the hook may induce acromial bony erosion, shoulder impingement, or even rotator cuff damage. By sonographic evaluation, we thus intended to determine whether the presence of hook plate may induce subacromial shoulder impingement and its relationship relative to surrounding subacromial structures. Read More

Turk Neurosurg 2013 ;23(6):803-6

Second Xiangya Hospital of Central South University, Department of Spinal Surgery, Changsha, China.

Orthopedic wires and pins are regularly used for the treatment of dislocations and bone fractures. Migration of these metallic fixation devices into the spinal canal is an uncommon complication. We present a 35-year-old man who underwent thoracic spinal canal migration of a Kirschner wire. Read More

Prim Care 2013 Dec 26;40(4):911-23, viii-ix. Epub 2013 Sep 26.

Department of Emergency Medicine, Robert C. Byrd Health Sciences Center, School of Medicine, West Virginia University, PO Box 9149, Morgantown, WV 26506, USA. Electronic address:

Injuries to the clavicle and associated structures may involve fractures of the clavicle or injuries to the surrounding joints, usually from a blow to the shoulder. They present with variable signs and symptoms, requiring a thorough history and physical examination. Diagnosis typically involves plain radiographs but more advanced imaging may be required, especially in the case of sternoclavicular joint dislocations. Read More

J Pediatr Orthop 2014 Jun;34(4):369-75

*Department of Orthopaedic Surgery, Boston Children's Hospital †Harvard Medical School, Boston, MA.

Background: Posterior injuries to the sternoclavicular (SC) joint are uncommon. In the skeletally immature (SI) population, these injuries have been described as either dislocations of the SC joint or fractures of the medial clavicular physis. The current literature and standardized test questions state that a posterior SC injury, in a SI patient, is more likely a physeal fracture than a SC joint dislocation. Read More

J Pediatr Orthop 2014 Jun;34(4):393-9

*Health Services Research Unit (HØKH) †Department of Orthopaedic Surgery, Akershus University Hospital ‡Institute of Clinical Medicine, University of Oslo, Lørenskog, Norway.

Background: Fractures of the clavicle are common among adolescents and have traditionally been treated nonoperatively. Recent literature has demonstrated less satisfactory results than expected after conservative management of displaced fractures in adults. The purpose of this study was to evaluate the long-term patient-reported outcome after clavicle fractures in older children and adolescents. Read More

J Shoulder Elbow Surg 2014 Mar 9;23(3):e47-52. Epub 2013 Aug 9.

Shoulder Unit, CTO Orthopedic and Trauma Center, Turin, Italy.

Hypothesis: Type IIA, IIB, and V lateral clavicular fractures (Craig modification of the Neer classification) are characterized by a constant displacement and are associated with a high rate of nonunion. The aim of this study is to verify whether the reduction and arthroscopic stabilization of these clavicular fractures with coracoclavicular cerclage provide stable fixation to allow for bone healing. To date, the treatment of these fractures is still controversial in young active patients in whom functional requirements are to be met. Read More

Bone Joint J 2013 Jun;95-B(6):815-9

Banaras Hindu University, Institute of Medical Sciences, Varanasi, Uttar Pradesh 221005, India.

Both conservative and operative forms of treatment have been recommended for patients with a 'floating shoulder'. We compared the results of conservative and operative treatment in 25 patients with this injury and investigated the use of the glenopolar angle (GPA) as an indicator of the functional outcome. A total of 13 patients (ten male and three female; mean age 32. Read More

Eur J Orthop Surg Traumatol 2013 Nov 16;23 Suppl 2:S179-82. Epub 2012 Oct 16.

Dallah Hospital, Riyadh, Saudi Arabia.

Although clavicle fractures are common, fracture dislocations of the medial end are rare. We report on a case of a 17-year-old patient who presented with a fracture of the medial clavicle with an associated anterior dislocation of the sternoclavicular joint. The patient underwent successful surgical management resulting in fracture union, restoration of shoulder stability and full functional range of motion at latest follow-up. Read More