Medial Clavicle Fracture with Posterior Dislocation of the Ipsilateral Acromioclavicular Joint Following Skiing Trauma

Introduction: Acromioclavicular joint (ACJ) dislocation combined with an ipsilateral medial clavicle fracture is extremely rare and results from high-energy shoulder trauma. This case report describes a medial clavicle fracture associated with ipsilateral ACJ dislocation, classified as type IV according to the Rockwood classification. Case Report: A 23-year-old male presented for an orthopedic consultation 1 week after a skiing accident in which he sustained direct trauma to his left shoulder upon impact with the ground. Radiographs and computed tomography (CT) scans of the left shoulder revealed a medial clavicle fracture with ipsilateral ACJ dislocation, classified as type IV according to the Rockwood classification. The patient was treated with an anterior 3.5 clavicle plate combined with an ACJ cerclage wire in a figure-eight configuration and a coracoclavicular endobutton placed arthroscopically. After a 6-month follow-up, the patient demonstrated excellent results in shoulder range of motion and function. The patient’s Constant-Murley score was 92. Conclusion: A medial clavicle fracture resulting from high-energy trauma should raise suspicion for a concomitant ACJ dislocation. To confirm this association, additional imaging studies, such as a shoulder CT scan, are essential. Keywords: Clavicle fractures, acromioclavicular dislocation, Rockwood grade IV, trauma.