Conversion of Neer Type II Closed Distal Clavicle Fracture to an Open Fracture Following Surgery Delay: A Case Report

INTRODUCTION: Type II distal clavicle fractures are associated with significant displacement and high rates of nonunion. Due to the risk of nonunion, these fractures are most often managed operatively soon after the injury. CASE REPORT: We present an 84-year-old male who sustained a Type II closed distal clavicle fracture that converted to an open fracture 1 month following initial injury. The patient underwent surgical repair with open reduction internal fixation and coracoclavicular ligament reconstruction. Following surgery, the patient experienced hardware failure with nonunion. He did not have any residual soft-tissue problems. CONCLUSION: Delaying surgical treatment of significantly displaced Type II distal clavicle fractures may pose a risk of conversion to open fracture. Surgeons should counsel their patients on this potential complication when discussing the risks and benefits of operative versus nonoperative treatment.