Concurrent treatment of a middle-third clavicle fracture and type IV acromioclavicular dislocation

Acromioclavicular (AC) dislocation with an associated displaced fracture of the middle third of the clavicle is a rare injury with no established standard treatment. Previous AC fixation techniques described have not included simultaneous internal fixation of the clavicle. We present the case of a 19-year-old man who sustained this combined injury pattern with a type IV AC dislocation. He underwent open reduction and internal fixation of the clavicle fracture with open reduction of the AC joint and coracoclavicular (CC) screw fixation through the plate to stabilize the AC dislocation. The CC screw was removed 3 months after surgery. By 1-year follow-up, the patient had returned to manual labor and normal activities of daily living. In comparison with previously described treatment, his case highlights a unique approach to this rare shoulder entity.