Abstract
In ipsilateral mid-clavicular and scapular-neck fractures, the mechanical stability of the suspensory structures is disrupted and muscle forces and the weight of the arm pull the glenoid fragment distally and anteromedially. To prevent late deformity we recommend internal fixation of the fractured clavicle. Fractures of the scapula are high-energy injuries. Clavicle fractures are common, usually being caused by a fall on an outstretched hand or a blow to the tip of the shoulder. Conservative treatment usually produces good or excellent results in injuries of the clavicle or of the scapula, but this is not so when both bones are injured simultaneously and when there is >2cm displacement of the lateral fragment of the clavicle. Several methods of fixation for lateral end of clavicle have been described. We treated this unusual injury with Intercostal drain insertion and Steinmann pin Fixation for the left clavicle fracture as there was impingement on the parietal pleura.
Highlights
The glenohumeral joint allows a wide range of movement in all directions, and the surrounding structure must provide stability without constraining these movements
The capsule, the glenohumeral, coracoclavicular, acromioclavicular and coracohumeral ligaments along with the deltoid, trapezius, pectoralis and rotator cuff muscles are the suspensory and stabilizing structures which help to maintain the stability in fractures involving the clavicle and the scapula[1,2]
When there is a fracture of both the surgical neck of the scapula and the clavicle, the scapular fracture becomes unstable and the weight of the arm and the muscles acting on the humerus pull the glenoid fragment distally and anteromedially[3,4,5]
Summary
The glenohumeral joint allows a wide range of movement in all directions, and the surrounding structure must provide stability without constraining these movements. The capsule, the glenohumeral, coracoclavicular, acromioclavicular and coracohumeral ligaments along with the deltoid, trapezius, pectoralis and rotator cuff muscles are the suspensory and stabilizing structures which help to maintain the stability in fractures involving the clavicle and the scapula[1,2]. When there is a fracture of both the surgical neck of the scapula and the clavicle, the scapular fracture becomes unstable and the weight of the arm and the muscles acting on the humerus pull the glenoid fragment distally and anteromedially[3,4,5]. In ipsilateral mid-clavicular and scapular-neck fractures, the mechanical stability of the suspensory structures is disrupted and muscle forces and the weight of the arm can pull the glenoid fragment distally and anteromedially and the pull of deltoid muscle can displace lateral fragment inferiorly. Conservative treatment usually produces good or excellent results in injuries of the clavicle, but this is not so when there is >2cm displacement of lateral fragment of clavicle
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