PMC5763060_01
Case 1: images at the first presentation. A radiograph shows type III ACJ dislocation.
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Initial radiographs and a computed tomography (CT) scan of the right clavicle showed type III ACJ dislocation (Figure 1) and anterior SCJ dislocation (Figure 2).
Case 1: a computed tomography scan shows anterior SCJ dislocation (arrow).
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Initial radiographs and a computed tomography (CT) scan of the right clavicle showed type III ACJ dislocation (Figure 1) and anterior SCJ dislocation (Figure 2).
Case 2: a three-dimensional reconstructed CT scan of the SCJ at 12 months' follow-up shows a reduced ACJ (arrowhead) and SCJ (arrow) with remaining 2.5 mm superior displacement of the clavicle (line).
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At 12 months' follow up, although a CT scan showed 2.5 mm residual superior displacement (Figure 6), it was not obvious on a physical examination.
PMC5763060_02
Case 2: images at the first presentation. (a) A radiograph shows type III ACJ dislocation. (b) A computed tomography (CT) scan shows posterior SCJ dislocation (arrow) as well as massive subcutaneous emphysema. (c) and (d) Three-dimensional reconstructed CT images of the left clavicle, which were made after the diagnosis was confirmed, clearly show ACJ dislocation (arrowhead) and posterior SCJ dislocation (arrow).
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The initial CT scan also showed posterior dislocation of the ipsilateral SCJ (Figure 3), but an SCJ lesion was overlooked in the emergency department.
Case 2: a radiograph taken after ACJ surgery.
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An emergency operation for the head injury was performed, and the ACJ injury was simultaneously fixed with a hook plate (Figure 4).
Case 2: intraoperative photographs of open reduction and augmentation of the SCJ. (a) Before reduction, the clavicle (arrow) was located behind the manubrium (arrowhead). (b) After reduction, the clavicle could maintain its position but was easily redislocated. (c) Three FiberWires were passed through a hole in the clavicle. (d) Sutures were also passed through holes in the manubrium and fastened to the surrounding soft tissue.
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Sutures were also passed through remnants of the ligaments and joint capsule, and all were fastened together (Figure 5).
Case 2: a three-dimensional reconstructed CT scan of the SCJ at 12 months' follow-up shows a reduced ACJ (arrowhead) and SCJ (arrow) with remaining 2.5 mm superior displacement of the clavicle (line).
CRIOR2017-2935308.006.jpg
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fig6
At 12 months' follow up, although a CT scan showed 2.5 mm residual superior displacement (Figure 6), it was not obvious on a physical examination.