Floating clavicle with medial clavicular fracture causing diagnostic dilemma - A case report and literature review

INTRODUCTION AND IMPORTANCE: A rare case of a fracture of the medial third of the clavicle on the basis of the “floating clavicle” was hereby reported. To the best of our knowledge, this complex clavicle fracture has not yet been published. This article aims to describe, for the first time, a case of the diagnosis and treatment of this special clavicle fracture. CASE PRESENTATION: The 26-year-old male patient suffered from a right sternoclavicular dislocation, a fracture of the right medial third of the clavicle, and a dislocation of the right acromioclavicular joint due to a car accident. In the course of treatment, he was missed diagnosis, and after active adjustment of treatment plan, good therapeutic effect was achieved. CLINICAL DISCUSSION: A special case of a floating clavicle was hereby reported. The missed diagnosis of sternoclavicular dislocation will cause great difficulties in the management of the disease. Based on the condition and clear diagnosis of the patient, surgical treatment was actively recommended for the patient. The selection of the implant for surgical treatment varied due to its specificity. A comprehensive literature review is also provided. CONCLUSION: Clavicular bone fracture is common in clinical practice. At the same time, the injury of sternoclavicular joint and acromioclavicular joint should be vigilant. For the complex clavicle fracture reported in this paper, the computed tomography scan with 3D reconstruction can assist in diagnosis. In the case of definite diagnosis, the use of a contralateral distal clavicular plate in combination with the conventional clavicular hook plate is an appropriate choice.