A Distal Clavicle Fracture With Unusual Displacement of the Medial Part: A Case Report

Suzanne F. Van Rijn*, Laurens Kaas, Annechien Beumer and Ronald Boer

A Distal Clavicle Fracture With Unusual Displacement of the Medial Part: A Case Report.

A distal clavicle fracture is a relatively uncommon injury. When a distal clavicle
fracture occurs, there is usually elevation of the medial part of the clavicle as
the lateral fragment is held in place with the acromioclavicular capsule. Hereby, we present a case of a 22-year-old
male with an unusual fracture dislocation of the distal clavicle.

A 22-year-old male presented himself at the emergency room with pain at the right shoulder
after a motor-bike accident. He had fallen on his right shoulder when driving approximately 35 km/h.

On physical examination, we found elevation of the distal clavicle with displacement
of the medial part caudally. There was pain on palpation. The piano key test was negative. The
skin was intact and without tension. Abduction and flexion of
the arm were painful. Neurovascular examination of the arm was normal.

The radiographs showed a distal clavicle fracture with an apparent disruption of the
AC joint. A CT-scan was obtained because physical examination and the
radiographs did not comply.

The CT-scan showed an intact AC-joint with a Neer type II B fracture pattern,
except for a dislocation of the medial fragment to dorso-caudal. After the
surgery the patient was allowed 90 degrees abduction and forward flexion of the right arm for six weeks.

Emerg Med Open J. 2016; 2(2): 39-41. doi: 10.17140/EMOJ-2-128