myatune.com.au • View topic - Longitudinal Clavicle Fracture

Recently had a client present with acute pain and swelling over his anterior chest and medial clavicle after a forceful throw to the ground while practicing martial arts. His arm was pinned into acute extension as his torso was thrown into the floor mat, driving the medial aspect of his clavicle forcefully anteriorly. He heard a crack at the time with immediate pain. He continued to train under some duress. He presented the following day for assessment. There was no visible fracture or shift in the alignment of the clavicle itself. The SC joint appeared to be driven anteriorly and medially.
The client presented 5/7 later and had massive bruising in both pecs and the mid sternal line. The patient had two x-rays between these treatments and neither investigation showed any abnormality. After the second assessment, the client contacted a orthopedic specialist friend who ordered a CT scan which showed the following:

: Note the 'split' through the inf/med aspect of the reading left clavicle..; photo 1.JPG (538.46 KiB) Viewed 804 times

: A more superior aspect view with shows the full extent of the fracture..; photo 2.JPG (348.32 KiB) Viewed 804 times

The fracture is stable and therefore doesn't need any further intervention. Management at the moment involves decreasing the reactive symptoms such as neck pain and headaches. The SCM has been particularly irritated and symptomatic..

A super interesting case and certainly something I didn't think possible - I would have thought that the force required to do this would have dislocated or subluxed the SC before it split the bone the way it has!! Nasty!