Case Report: Management of Segmental Clavicle Fracture Using Lateral End Clavicle Plate

Background: Segmental clavicle fractures are very rare, with few articles described in English literature. Most commonly clavicle fracture occurs in the diaphysis followed by lateral end and least in the medial end. Segmental clavicle fracture occurs when there is a high energy trauma and is usually associated with other injuries like rib fracture or pneumothorax. They occur less often after direct trauma, and this has been the mechanism described in segmental fractures in which there is generally multiple trauma in the clavicle. The diagnosis is simple with local examination and radiographs as clavicle is a subcutaneous bone. In contrast to simple clavicle fractures which give good results without surgery, segmental clavicle fractures need to be surgically fixed early due to loss of blood supply of the fractured segments. Case Presentation: A 47 yr old female presented to kurla babha hospital opd with complaints of pain in the right shoulder following a history of fall from stairs. On examination she had swelling on the right side of her supraclavicular area and there was tenderness on palpation of the medial and lateral end of clavicle. She was having difficulty in moving her right shoulder. She was advised to get a radiograph done of the right clavicle with shoulder which revealed segmental clavicle fracture. She was given figure of 8 splint and was admitted in ward. Routine investigations were sent and she was posted for surgery after 2 days. Open reduction and fixation was done with the use of lateral end clavicle plate. Post op patient was stable and was shifted to ward. Post op dressing was clean with no complications. She was then discharged on 5th post op day and was advised to follow up in OPD. Conclusion: Segmental clavicle fractures are rare with few case reports being described in literature. Diagnosis requires careful radiographic examination in various views. Surgical management gives a good outcome. But care has to be taken to watch for any complications like lung injury, rib fractures or head injury which are usually accompanied with segmental clavicle fractures.