Clavicular Refracture at the Site of Angular Malunion in Young Athletes.

OBJECTIVE

The treatment of midshaft clavicle fractures has, in the last 2 decades, shifted markedly towards operative management. Prospective trials have defined accepted clinical and radiographic indications for the surgical management of clavicle fractures. This report documents 3 cases of clinically united angular malunion of the midshaft clavicle in young athletes that subsequently refractured to highlight angular deformity in the absence of displacement as a potential indication for surgical fixation.

DESIGN

Case series.

SETTING

A level 1 trauma centre.

PATIENTS/PARTICIPANTS: Three young athletic patients with angular malunion of the midshaft clavicle who experienced refracture, requiring surgical fixation.

INTERVENTION

Surgical fixation of midshaft clavicle fracture, as treatment for refracture after angular malunion.

RESULTS

All 3 patients required subsequent surgical fixation of their midshaft clavicle fracture, correcting the angular malunion and restoring shoulder function.

CONCLUSIONS

Midshaft clavicular fractures that malunite with significant angulation in the absence of displacement represent a risk for subsequent refracture. For this reason, angular deformity should be considered as a potential indication for surgical fixation in acute clavicular fractures.

LEVEL OF EVIDENCE

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.