Lateral Clavicular Physeal Separation

Lateral clavicle separations are extremely rare injuries, and recognition of the extent of the injury is the first step in having a good outcome. The mechanism of the injury in this case was a direct blow to the anterior surface of the clavicle causing failure of the lateral physis and then displacing in an arc posteriorly pivoting on the medial sternoclavicular joint to end up imbedded in the supraspinatus muscle above the scapular spine. The patient was seen by two other orthopedic surgeons who failed to recognize the severity of the injury. The patient was operated on successfully illustrating the mechanism and extent of the injury. This case illustrates the importance of recognition, mechanism, pathogenesis, and basic principles of reduction and repair.