Abstract

Clavicle fractures account for a significant proportion of shoulder girdle injuries, with an estimated annual incidence of approximately 29 per 100,000 population. Distal (lateral-end) clavicle fractures represent a clinically important subgroup because disruption of the coracoclavicular ligament complex frequently results in fracture instability and displacement. Consequently, these injuries have a higher incidence of delayed union and non-union than fractures involving the middle third of the clavicle. The usual mechanism of injury is a direct impact to the lateral aspect of the shoulder or a fall onto the shoulder, commonly occurring during sports activities, falls, or road traffic accidents. Patients typically present with shoulder pain, swelling, tenderness, restricted range of motion, and, in displaced fractures, a visible deformity over the lateral clavicle. Although non-operative treatment may be appropriate for selected stable fractures, displaced unstable distal clavicle fractures often require surgical stabilization to restore anatomical alignment, promote fracture union, and facilitate early functional recovery. Various operative techniques have been described, including locking plate fixation, hook plate fixation, coracoclavicular screw fixation, Kirschner (K)- wire fixation, tension-band wiring, intramedullary fixation, and coracoclavicular suture augmentation. We report the case of a displaced lateral-end clavicle fracture treated with open reduction and internal fixation using two 2.0-mm Kirschner wires combined with coracoclavicular stabilization using No. 5 FiberWire. Early supervised shoulder mobilization was initiated three weeks postoperatively, resulting in satisfactory fracture union and a good functional outcome.

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