Bipolar fracture of clavicle mimicking fracture dislocation of sternoclavicular joint: A case report

Int J Surg Case Rep. 2024 May:118:109632. doi: 10.1016/j.ijscr.2024.109632. Epub 2024 Apr 5.

Abstract

Introduction and importance: Bipolar fractures involving segmental fractures of the lateral and proximal clavicles are exceptionally rare, with only isolated cases documented in the literature. Such fractures may easily be overlooked during the initial presentation.

Case presentation: We present the case of a 35-year-old male with deformation in the middle segment of the clavicle following a road traffic accident (RTA). On radiography, the injury was initially thought to be a lateral clavicle fracture combined with sternoclavicular joint dislocation but was later changed to a bipolar clavicle fracture intraoperatively. The patient had an uneventful postoperative course with excellent functional outcomes 14 months after surgery.

Clinical discussion: A bipolar clavicle fracture is the result of direct trauma to the shoulder region commonly following RTA. Bipolar injuries can be diagnosed based on clinical findings and radiographic evaluation using plain X-rays and aided by computed tomography (CT) scans in doubtful scenarios. With a paucity of guidelines regarding the management of bipolar clavicle fractures most reported cases have been managed operatively with open reduction and internal fixation using locking plates and screws.

Conclusions: Due to its rarity, bipolar clavicle fractures can be easily missed, necessitating a high index of suspicion and detailed evaluation of suspected cases. Appropriate initial and definitive management through operative fixation can lead to optimal outcomes.

Keywords: Clavicle; Fractures; Open fracture reduction.

Publication types

  • Case Reports