Simultaneous bilateral midshaft clavicle fractures (Allman Type I): Case series

Abstract

Rationale: A simultaneous bilateral fracture of the middle clavicle is a very rare injury in clinical practice, and the necessity of surgical intervention and treatment modality remains a topic of debate. Patient concerns: We report a case of multiple injuries in a 40-year-old woman following a road traffic accident and another case of polytrauma in a 46-year-old man following a collision injury. Diagnoses: The radiographs of the bilateral shoulder joints and the 3-dimensional reconstruction CT of the chest showed the fractures in the middle third of the clavicle on both sides. In addition, concurrent injuries were not overlooked. Interventions: Until the patient's life-threatening injury is prioritized and the patient's vital signs are stable, patients were treated with the anatomical locking plate to stabilize the bilateral clavicle fractures. Progressive functional exercises were implemented following the operation. Outcomes: At the 2-month follow-up examination, the patients showed excellent range of motion and functional outcomes. Lessons: Given the rarity of this combined injury, it is crucial to minimize the duration of functional impairment and encourage early functional exercises for both shoulder joints. We recommend that surgical indications be judiciously relaxed to allow for open reduction and internal fixation using locking plates.