Bipolar Injury of the Clavicle

Eleven patients with bipolar clavicle injuries, including dislocation of both ends of the clavicle, dislocation of the sternoclavicular joint with distal clavicle fracture, dislocation of the acromioclavicular joint with medial clavicle fracture, and segmental fracture of the clavicle, were retrospectively reviewed. The purpose of this study was to report the clinical outcomes and a literature review of bipolar clavicle injury. Nonoperative treatment was performed for 5 patients and surgical treatment for 6 patients. The fracture or dislocation of the lateral end of the clavicle was fixed with a hook plate, and closed reduction of the medial end was performed; if the dislocation was still present, open reduction and anterior sternoclavicular ligament repair was performed. Visual analog scale pain score, Constant score, active range of motion, and radiological images were evaluated. The mean visual analog scale pain score for all patients was 0.7±0.9 (range, 0-2). The mean Constant score for all patients was 89.7±7.6 (range, 72-96). The mean Constant score was 84.2±8.5 (range, 72-96) for conservatively treated patients and 94.3±1.9 (range, 92-96) for surgically treated patients. The mean Constant score was 83.4±7.2 (range, 72-92) for patients in whom optimal reduction of 1 or both ends was not achieved. Residual pain or deformity was seen in 5 patients. The authors suggest operative treatment of bipolar clavicle injuries in younger, active patients when anatomical reduction cannot be achieved and residual deformity, pain, or functional limitations are unacceptable. [Orthopedics. 2018; 41(5):e681-e688.].