PMC6180938_01
Preoperative anteroposterior radiographs revealing an asymmetric position of the medial clavicle on the right side.
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fig2
Standard radiographs revealed an asymmetric position of the medial clavicle with posterior displacement of the medial end on the injured side (Figure 2).
Axial (a) and three-dimensional reconstructed (b) computed tomography scans confirm the posteriorly displaced clavicle on the right side. Due to the absence of the corresponding centers of ossification of the medial clavicular epiphysis, discrimination from a pure posterior dislocation of the sternoclavicular joint is difficult.
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fig3
CT scan confirmed the diagnosis of epiphysiolysis of the medial clavicular epiphysis (Figures 3(a) and 3(b)).
Surgical technique: fixation of the reduced clavicular metaphysis with three transosseous sutures (FiberWire ) on the anterior clavicular periosteum (a). The clavicular metaphysis is fixed, and the periosteum is closed by tightening the knots (b).
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fig4
Three FiberWire  were inserted in the holes, and the metaphysis was anchored directly to the strong and solid anterior clavicular periosteum (Figures 4(a) and 4(b)).