title: EXTRA-ARTICULAR FRACTURE OF THE MEDIAL END OF THE CLAVICLE ASSOCIATED WITH TYPE IV ACROMIOCLAVICULAR DISLOCATION: CAAE REPORT.
abstract: Fractures of the clavicle and acromioclavicular dislocations are very common injuries when they occur separately. The combination of an acromioclavicular dislocation and a fracture of the lateral third of the clavicle is not rare. However, there are very few reported cases of acromioclavicular dislocations associated with fractures of the middle third of the clavicle; those associated with fractures of the medial third are even rarer. We report the case of an adult male who suffered an acromioclavicular dislocation (type IV) associated with a displaced extra-articular fracture of the medial end of the clavicle (Almann group 3) in a cycling accident. The patient was treated during the acute phase with open reduction and internal fixation of the two lesions. At the clinical evaluation 12 months after the surgery, the patient was asymptomatic, with full active and passive mobility, and normal strength and endurance of the shoulder girdle. Radiographs and a three-dimensional CT scan showed persistent posterosuperior subluxation of the acromioclavicular joint and anatomical consolidation of the clavicular fracture.
authors.affiliation: Attending Physician in the Specialization Program on Shoulder and Elbow Surgery (CECOC), Hospital Mother Teresa, Belo Horizonte, MG; Orthopedist at Hospital, Governador Israel Pinheiro (HGIP-IPSEMG), Belo Horizonte, MG, Brazil.
authors.forename: Mário Chaves
authors.initials: MC
authors.lastname: Correa
authors.affiliation: Attending Physician in the Specialization Program on Shoulder and Elbow Surgery (CECOC), Hospital Mother Teresa, Belo Horizonte, MG, Brazil.
authors.forename: Lucas Braga Jacques
authors.initials: LB
authors.lastname: Gonçalves
authors.affiliation: Attending Physician in the Specialization Program on Shoulder and Elbow Surgery (CECOC), Hospital Mother Teresa, Belo Horizonte, MG, Brazil.
authors.forename: Jose Carlos Souza
authors.initials: JC
authors.lastname: Vilela
authors.affiliation: Specialization Program on Shoulder and Elbow Surgery (CECOC), Hospital Mother Teresa, Belo Horizonte, MG, Brazil.
authors.forename: Igor Lima
authors.initials: IL
authors.lastname: Leonel
authors.affiliation: Orthopedist at Hospital Mother Teresa, Belo Horizonte, MG, Brazil.
authors.forename: Lincoln Paiva
authors.initials: LP
authors.lastname: Costa
authors.affiliation: Head of the Orthopedics and Traumatology Service, Hospital Mother Teresa, Belo Horizonte, MG, Brazil.
authors.forename: Ronaldo Percopi
authors.initials: RP
authors.lastname: de Andrade
keywords: Acromioclavicular Joint; Dislocation/surgery; Shoulder Fractures