The Second Fracture of the Same Clavicle:
Prevalence and Fracture Configurations
Apichat Asavamongkolkul MD*,
Thos Harnroongroj MD*, Wuttipon Suteeraporn MD*,
Narumol Sudjai BSc*, Thossart Harnroongroj MD*
Affiliation :
* Department of Orthopedics Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Objective : To study second fracture at the same clavicle including prevalence, fracture configurations related to malunion
types of the first fracture, and healing.
Material and Method: Between 2008 and 2011, the authors reviewed medical records and radiographs of the clavicles of
patients who sustained acute clavicular fractures from motorcycle accident. Second fracture at the same clavicle and
prevalence were studied. Malunion of the first fracture of the same clavicle were typed and configurations of the second
fracture at the same clavicles were described related to type of the malunion.
Results : There were 552 clavicular fractures. Four cases of which sustained a second fracture at the same clavicles. Malunion
of the first clavicular fracture of the four cases were typed: type I, extension, type II, flexion, and type III, bayonet. There
were one, two, and one case of second clavicular fractures of the type I, II, and III clavicular malunion. The configuration
of second clavicular fracture of the type I malunion clavicle is located at lateral fragment, inferior displacement, and dorsal
angulation with dorsal cortex conminution. The type II malunion clavicle is located at lateral fragment with minimal
displacement. For the Type III malunion clavicle, the second fracture is located at medial fragment with mild inferior
displacement and inferior angulation. The four cases of the second fractures of the same clavicles healed within two months
without complication.
Conclusion : The prevalence of second fracture at the same clacicles was 7.2:1,000. The three types of the first fracture
malunion were extension, flexion, and bayonet. The configuration of the second fracture at the same clavicles depends on
malunion types of the first clavicular fracture. They healed without complication.
Keywords : Second fracture of the same clavicle, Prevalence, Fracture configurations, First fracture malunion types, Healing
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