• bipolar dislocation
• bipolar injury
• floating clavicle
• pan-clavicular dislocation
• surgical management

• Clavicle
• Fractures
• Open fracture reduction

Shoulder injuries caused by trauma are common, including clavicle fractures. Even so, bipolar segmental fracture of the clavicle is extremely rare and seldom reported. Therefore, there is still a controversial issue about how to treat these bipolar segmental clavicle fractures.

A 56-year-old security guard arrived at our emergency room after falling on his electric bicycle. There was no loss of consciousness or other pain. He had no numbness in his fingers. X-rays and 3D computed tomography revealed that the patient's right shoulder had a bipolar segmental clavicle fracture. The surgical procedure included both open reduction and internal fixation. At the 1-year follow-up, he had a full range of motion and minimal discomfort in the injured shoulder.

We provide a rare case of bipolar clavicle facture in the right clavicle. We hold the opinion that such patients would get better clinical and radiological outcomes by early and correct operation.

• Bipolar segmental clavicle fracture
• Arm sling
• Open reduction and internal fixation
• Acromioclavicular hook plate
• Case report

• bipolar clavicle fracture
• case report
• surgical fixation
• treatment

• Aged
• Bone Plates
• Clavicle/diagnostic imaging
• Clavicle/injuries
• Clavicle/surgery
• Fracture Fixation, Internal/methods
• Fractures, Bone/diagnostic imaging
• Fractures, Bone/surgery
• Humans
• Male
• Treatment Outcome

Clavicular fractures are common, accounting for 4% of all adult fractures. However, simultaneous medial and lateral fractures occurring in the same clavicle (the so-called ‘bipolar clavicle fracture’) are rare. Treatment for this type of fracture is not well established. Herein, we report our experience of the operative management of a bipolar clavicle fracture using two anatomical locking plates.

The patient was an 82-year-old woman who presented with left-sided clavicle pain after falling to the ground. Plain radiography revealed midshaft and distal clavicular fractures. Open reduction and internal fixation were performed using two different plates, the VA-LCP anterior clavicle plate (DePuy Synthes, West Chester, PA, USA) for the midshaft fracture and the LCP superior anterior clavicle plate with lateral extension (DePuy Synthes) for the distal clavicle fracture. Bony union was achieved 4 months postoperatively without any complications.

In conclusion, dual plating is an effective surgical procedure for treating bipolar clavicle fractures.

• Anatomical locking plate
• Bipolar clavicle fracture
• Dual plating
• Open reduction and internal fixation

•

Rare case of traumatic bipolar clavicular over an ipsilateral reverse shoulder prosthesis.

Bipolar clavicular fractures are extremely rare with no consensus on management. No previous cases of bipolar clavicular fracture on an ipsilateral reverse shoulder prosthesis have been reported.

We report a case of a 78y.o female patient with left bipolar clavicular fracture on ipsilateral reverse shoulder prosthesis, associated with multiple ribs fracture, that was treated with open reduction and internal fixation using k-wires and endobutton for the lateral part, while as the medial part was fixed with plate and screws.

Any patient with a clavicle fracture, with a history of sequential forces to the clavicle, a bipolar injury should always be suspected. Attention should be given if any implants are present on the ipsilateral side of the injury, which could affect surgical planning and outcome.

• Bipolar
• Clavicle
• Fracture
• Reverse shoulder prosthesis
• Trauma

Medial third clavicle fractures are rare injuries, with limited information available on their characteristics or treatment results.

We performed a systematic review according to PRISMA guidelines to evaluate the demographics, clinical profile, management and treatment outcome. Electronic searches of the MEDLINE, EMBASE and Cochrane databases were performed.

Seventeen studies were included, consisting of 7 case series and 10 case reports. Two hundred twenty fractures were identified. Seventy-eight percent of fractures occurred in men with mean age of 48 years (16–94 years). Road traffic accident was the most common mechanism of injury (64%). Associated injuries occurred in 81% of patients, with thoracic trauma being the most common (47%). The most common fracture type was extra-articular, with no or minimal displacement (60%). In 9% of patients the fracture was segmental. One hundred ninety-one patients received nonoperative treatment. Twenty-nine patients were treated operatively. The overall nonunion rate was 5% (7/137). The nonunion rate following nonoperative management was 4.6% (5/108). The functional result following nonoperative treatment indicated overall “good” functional outcome. There was no report of catastrophic intraoperative complication amongst patients undergoing surgical fixation.

Medial third clavicle fractures represent a distinct subgroup of clavicle fractures. Nonoperative treatment of these fracture seems to result in high union rate and overall favourable functional outcome. Further high-quality research in this area is warranted to investigate the outcomes and indication for nonoperative versus operative management of these fractures.

IV.

• Medial clavicle fracture
• Nonunion
• Open reduction internal fixation
• Systematic review