Midshaft clavicle fracture with hypertrophy of the fractured end

Abstract

Abstract Introduction: Midshaft clavicle fractures are common fractures, but clavicle fractures with hypertrophy of the fractured end are rare. To the best of our knowledge, there are no reports describing this peculiar form of fracture. Patient concerns: A 68-year-old woman was admitted to the orthopedic department for treatment of left shoulder joint swelling and pain with limited mobility for 1 day duration She had a history of falls and an old left distal radius fracture, but no history of left shoulder joint swelling, pain, and limited mobility. Diagnosis: 1. Midshaft fracture of the left clavicle 2. Motor neuron injury 3. Multilevel cervical intervertebral disc herniation. 4. Brain atrophy 5. Old left distal radius fracture. Interventions: Surgical treatment was performed after detailed preoperative evaluation. During surgery, the clavicle fracture was anatomically reduced under direct vision (unusually, the fracture end was displaced during intraoperative fluoroscopy). After fracture reduction, one eight-hole locking plate was fixed with three locking screws at each end of the fracture. After the surgery, the patient was instructed to perform rehabilitation training. Outcomes: The sutures were removed on the 12th postoperative day, and the incision wound healing was good. Follow-up at one month after surgery revealed no swelling or pain at the left clavicle fracture site and both active and passive ranges of motion of the left shoulder joint were good. Conclusion: For clavicle fractures with hypertrophy of the fractured ends in the elderly, after excluding pathological fractures caused by tumors, satisfactory results can be obtained as long as strong internal fixation is achieved. In the midshaft clavicle fracture with hypertrophy of the fractured end, whether to achieve the reduction criteria under direct vision or intraoperative fluoroscopy imaging should be determined on the basis of the patient's actual condition. Motor neuron injury may promote the healing of clavicle fractures due to restricted motor function that promotes fracture healing.