PMC8343839_01
Preoperative X-ray and computed tomography scan showing a midshaft clavicle fracture and ipsilateral sternoclavicular dislocation (white arrow).
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F1
The radiographs showed a minimally displaced midshaft fracture of the left clavicle and a suspected anterior dislocation of the left SC joint (Figure 1). Computed tomography (CT) scans confirmed the diagnosis and showed an anterior SC dislocation without any signs of a neurovascular injury (Figure 1).
Intraoperative images of a concurrent anterior SC dislocation and midshaft clavicle fracture treated with open reduction, transosseous suturing of the sternoclavicular joint, and plating of the clavicle.
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F2
A 20-cm incision from the SC joint to the transition of the middle to lateral third of the clavicle was performed (Figure 2).
Constant-Murley Score at follow-up examinations. The affected left side improved continuously from 4 to 12 weeks postoperatively.
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F3
Score (CMS) showed 35/100 points (39% compared to the unaffected side) (Figure 3) with an apparent decrease in strength and ROM. Shoulder function continuously improved, and fracture healing could be confirmed after eight weeks without any signs of redislocation.
X-rays at 12 weeks postoperatively showing complete healing of the midshaft clavicle fracture and satisfactory plate positioning with minimal superior displacement of the medial clavicle.
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F4
ROM in abduction and flexion, and slight remaining decrease in strength and internal rotation. Clinical examination showed a recurring prominence of the medial clavicle without any signs of instability on palpation. Radiographs indicated a 5-mm superior displacement of the medial clavicle (Figure 4) with the midshaft clavicle fracture healed and satisfactory plate positioning.