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BMC Musculoskelet Disord 2021 Jun 9;22(1):528. Epub 2021 Jun 9.

Division of Arthroscopy, Joint Surgery and Sport Injuries, Department of Orthopedics, Trauma, and Plastic Surgery, University of Leipzig, Liebigstrasse 20, 04103, Leipzig, Germany.

Background: The purpose of this study was to present a navigated image-free augmentation technique for the acromioclavicular joint (ACJ) and coracoclavicular (CC) ligaments and to report the clinical and radiological outcomes.

Methods: From 2013 to 2018, 35 eligible patients were treated with our navigated image-free ACJ- and CC-augmentation technique. The average follow-up was 3 years. Read More

Orthop Traumatol Surg Res 2021 May 22:102965. Epub 2021 May 22.

Service de Chirurgie de l'Arthrose et du Sport, Urgences Traumatiques des Membres. CHU de Grenoble-Alpes, Hôpital Sud, Avenue de Kimberley, BP 338, 38434, Échirolles, Cedex, France.

Introduction: Shoulder trauma with normal radiographs is a frequent emergency presentation. The predominance of pain makes clinical examination unreliable, and complementary imaging is often needed for diagnosis. The aim of the present study was to assess the contribution of ultrasonography (US) and magnetic resonance imaging (MRI) in deciphering such trauma. Read More

Trauma Case Rep 2021 Jun 21;33:100483. Epub 2021 Apr 21.

Starship Hospital Orthopaedic Department, 2 Park Road, Grafton, Auckland 1023, New Zealand.

The primary stabiliser of the diarthrodial sterno-clavicular (SC) joint is the costo-clavicular ligament, this holds the clavicle to the first costal cartilage and the end of the first rib. The costo-clavicular and surrounding ligaments help maintain the stability and strength of the SC joint. As a result, SC joint dislocations are far less common than fractures to the clavicle due to the relatively larger forces required to disrupt these ligaments. Read More

Zhongguo Gu Shang 2021 03;34(3):234-6

Department of Emergency, the First People's Hospital of Shangqiu, Shangqiu Clinical College of Xuzhou Medical University, Shangqiu 476000, Henan, China.

Am J Case Rep 2020 Oct 12;21:e924889. Epub 2020 Oct 12.

Department of Orthopaedics, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China (mainland).

BACKGROUND Bipolar dislocation of the clavicle is a rare disease that is often associated with some high-energy injuries. It refers to concomitant dislocation of the ipsilateral acromioclavicular joint and sternoclavicular joint. Because of its rarity, the diagnosis of bipolar dislocation of the clavicle is often difficult. Read More

Medicine (Baltimore) 2020 Sep;99(39):e22324

Orthopaedic Medical Center, the Second Hospital of Jilin University, Changchun, China.

Rationale: Coracoid processes (CPs) fracture with acromioclavicular (AC) joint dislocation are extremely rare. This combined injury has brought many challenges to surgeons, and the mechanism underlying the injury is still not fully understood. There is no clear consensus on its treatment. Read More

J Shoulder Elbow Surg 2020 Jul;29(7S):S92-S100

Steadman Hawkins Clinic of the Carolinas, Prisma Health-Upstate, Greenville, SC, USA.

Background: The management of high-grade acromioclavicular separations remains unclear. The surgical interventions have shifted to more anatomic, less invasive techniques. The purpose of this study was to systematically review the outcomes and complications of anatomic coracoclavicular ligament reconstruction using a tendon graft. Read More

Int Orthop 2021 04 20;45(4):1009-1015. Epub 2020 May 20.

Institute of Anatomy, First Faculty of Medicine, Charles University Prague, Prague, Czech Republic.

Purpose: Until now, classifications of coracoid fractures have been based on plain radiographs, without use of 3D CT reconstructions. Therefore, the aim of the present study has been to describe the pathoanatomy of these fractures and their associated injuries to the shoulder girdle, on the basis of 3D CT reconstructions.

Methods: The cohort comprised 39 patients, who each sustained a coracoid fracture investigated with 3D CT reconstructions. Read More

Radiologe 2020 Jun;60(6):541-548

Unfallchirurgische Klinik, Medizinische Hochschule Hannover, Hannover, Deutschland.

Background: The shoulder girdle is a chain of bones and joints which connect the upper extremity to the axial skeleton. The shoulder as a biomechanical unit has a remarkable range of motion and is therefore frequently prone to injuries of the three major joints (sternoclavicular joint, acromioclavicular joint, glenohumeral joint) and the bony elements (clavicle, scapula, humerus). Projection radiography is still the first imaging modality for injuries of the shoulder and usually sufficient for initial diagnosis and injury classification. Read More

Medicine (Baltimore) 2019 Dec;98(51):e18433

Department of Orthopedics and Traumatology, San Raffaele Scientific Institute.

Rationale: Posterior sternoclavicular joint dislocations (PSCJDs) are particularly rare injuries, accounting for 3% to 5% of sternoclavicular joint dislocations. With very few cases reported in the literature, these injuries are often misdiagnosed and imaging is not always clear, thus making physicians often unaware of them. The present case report aims to investigate a rare case involving a clavicular Salter-Harris II fracture with associated posterior displacement of the diaphysis, a term coined a "pseudodislocation. Read More

Emerg Med Clin North Am 2020 Feb;38(1):103-124

Department of Emergency Medicine, Feinberg School of Medicine, Northwestern University, 211 East Ontario Street, Suite 200, Chicago, IL 60611, USA; United States Soccer Federation.

Shoulder pain is a common presentation in the emergency department. The list of differential diagnoses is broad. This article summarizes common diagnoses of shoulder pain, including bony, infectious, and connective tissue pathologies and their proper treatment. Read More

J Orthop Trauma 2019 Nov;33(11):e439-e446

Department of Orthopaedic Surgery, The Warren Alpert Medical School of Brown University, Providence, RI.

Objectives: The purpose of this study was to systematically review and quantitatively analyze outcomes in operative versus nonoperative management of displaced midshaft clavicle fractures in pediatric and adolescent patients.

Data Sources: Using the Preferred Reporting items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, systematic searches of PubMed and EMBASE were conducted to identify English-language studies reporting outcomes in displaced pediatric midshaft clavicle fractures from 1997 to 2018.

Study Selection: Studies that reported on outcomes of operative and/or nonoperative treatment of displaced midshaft clavicle fractures in patients younger than 19 years were included. Read More

J Bone Joint Surg Am 2019 Aug;101(15):1335-1341

The Shoulder Injury Clinic, Edinburgh Orthopaedic Trauma Unit, Edinburgh, United Kingdom.

Background: Fractures of the lateral aspect of the clavicle with complete displacement have a high nonunion rate and are associated with poor functional outcomes following nonoperative treatment. Various techniques are available to treat these fractures, but preliminary studies of open reduction and tunneled suspensory device (ORTSD) fixation have shown good early functional outcomes with a low rate of complications; our goal was to assess the functional outcomes and complications in the medium term in a larger series of patients treated using this technique.

Methods: Sixty-seven patients with displaced lateral-end clavicular fractures were treated with ORTSD fixation. Read More

Medicine (Baltimore) 2019 Jul;98(28):e16359

Department of Orthopedics.

Rationale: Asymmetrical bilateral sternoclavicular joint (SCJ) dislocation consists of posterior SCJ dislocation on one side and anterior SCJ dislocation on the other side. This is an extremely rare injury and only a few cases have been reported in the literature. If not been diagnosed timely and accurately, asymmetrical bilateral SCJ dislocation can be life-threatening. Read More

Orthop J Sports Med 2019 May 31;7(5):2325967119847470. Epub 2019 May 31.

Institute of Sports Imaging, National Institute of Sport, Expertise, and Performance, Paris, France.

Background: Judo is a full-contact fighting sport that may lead to severe injuries. There are limited data available on the incidence of judo-related injuries. The French Judo Federation has established a surveillance system to document the frequency and type of injuries during judo competitions. Read More

Radiol Clin North Am 2019 Jul 6;57(4):809-822. Epub 2019 Apr 6.

Department of Diagnostic and Interventional Imaging, McGovern Medical School, The University of Texas Health Science Center at Houston, 6431 Fannin Street, 2.130B, Houston, TX 77030, USA.

Shoulder girdle trauma is one of the most common injuries encountered in emergency centers. These injuries can be easily overlooked due to the complex osteology of the shoulder. Although radiographs are usually sufficient for assessing traumatic shoulder injuries, cross-sectional imaging is sometimes indicated to assess portions of the shoulder not well visualized by radiographs. Read More

Clin Orthop Surg 2019 Mar 18;11(1):103-111. Epub 2019 Feb 18.

Department of Orthopaedic Surgery, Eulji Hospital, Eulji University School of Medicine, Seoul, Korea.

Background: Arthroscopic stabilization of torn coracoclavicular (CC) ligaments gained popularity recently. However, loss of reduction after the operation and complications unique to this technique involving tunnel placement through the distal clavicle and coracoid process are concerns. The purpose of this study was to report intraoperative and early postoperative complications associated with this procedure. Read More

Eur J Med Res 2018 Oct 23;23(1):50. Epub 2018 Oct 23.

Department of Trauma Surgery, Klinikum rechts der Isar, Technical University of Munich, Germany, Ismaninger Strasse 22, 81675, Munich, Germany.

Background: The primary goal of this study was to analyse the anatomic configuration of the acromio-clavicular joint in a healthy population to be able to develop a classification in a second step. On the basis of the primary findings a secondary goal was to find potential clinical indications in refer to AC-joint dislocation and lateral clavicle fractures.

Methods: The upper thoracic aperture including both shoulder joints as well as both sterno-clavicular joints was retrospectively reformatted in a bone kernel in axial orientation with 0. Read More

J Orthop Trauma 2018 11;32(11):e435-e439

Department of Trauma Surgery, Leiden University Medical Center, Leiden, The Netherlands.

Objectives: To evaluate mid-term patient-reported satisfaction and residual symptoms after plate fixation (PF) or nonoperative treatment (NOT) for displaced midshaft clavicular fractures.

Design: Follow-up survey of randomized controlled trial.

Setting: Sixteen teaching and nonteaching hospitals. Read More

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

J Orthop Trauma 2018 07;32(7):e276-e283

Orthopaedic Surgery Department, Hamad General Hospital, Doha, Qatar.

Objectives: To compare open reduction and internal fixation (ORIF) and nonsurgical treatment outcomes in displaced midshaft clavicle fractures.

Data Sources: PubMed, MEDLINE, EMBASE, Web of Science, Cochrane Library, and ClinicalTrials.gov were searched in September 2017. 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 Orthop Trauma 2018 04;32(4):204-210

Department of Orthopaedics, University of Utah School of Medicine, Salt Lake City, UT.

Objectives: To analyze the functional and radiographic outcomes of anatomic coracoclavicular ligament reconstruction (ACCR) using allograft tendon without interference screw fixation.

Design: Retrospective nonrandomized study.

Setting: Level I trauma center (University Hospital). 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

Orthopade 2018 Feb;47(2):148-157

Klinik für Unfall- und Handchirurgie, ViDia Christliche Kliniken Karlsruhe, St. Vincentius-Kliniken, Südendstr. 32, 76135, Karlsruhe, Deutschland.

In recent years, the understanding of shoulder fractures has changed due to the progress of arthroscopy. In addition to the cosmetic result, the access morbidity, particularly the integrity of the subscapularis muscle in glenoid and scapular fractures, must be mentioned as an advantage of a minimally invasive approach. Furthermore, necessary secondary interventions, e. 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