PMC7196132_01
X-ray imaging showing the nondislocated fracture on the day of presentation to the paediatric A&E.
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The X-ray demonstrated a nondisplaced fracture of the middle to proximal third of the right clavicle (Figure 1).
X-ray imaging showing callus formation after three months.
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The patient was an amateur junior javelin thrower and was restricted from all sporting activity for a total of 3 months and until there was radiographic confirmation of callus formation (Figure 2).
X-ray imaging showing partial callus formation, hypertrophic nonunion, and deformation at the boundary of the midshaft and proximal right clavicle.
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The X-ray at 12 months confirmed the clinical suspicion of a pseudoarthrosis (Figure 3).
CT scan confirmed the diagnosis of the pseudoarthrosis.
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The MRI was useful in excluding an entrapment of surrounding articular structures and in evaluating the involvement of the neurovascular bundle with respect to the bone (Figure 4).
Postoperative X-rays.
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Following bone tissue transplant, the clavicle was reduced and internal fixation performed with a 3.5 mm seven-hole locking compression plate (LCP) (Synthes) in compression (Figure 5). Following a normal postoperative course, clinical and radiological follow-up showed complete isometric anatomical healing at 1 year from the operation (Figure 5).
X-ray imaging at 1 year.
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The clinical examination showed no pain during shoulder movement, with a range of motion in antepulsion of 180 , abduction of 180 , internal rotation up to X thoracic vertebra, and external rotation of 80  (Figure 6).