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Review Question - QID 7853

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QID 7853 (Type "7853" in App Search)
A 22-year-old professional X-games motocross bike rider is thrown from his ride during a jump. He lands directly onto the point of his left shoulder and feels sharp pain. Examination reveals mild deformity over the lateral clavicle and bruising. A radiograph is shown in Figure 65. What is the most appropriate treatment?
  • A

Sling and swathe

3%

22/629

Kenny-Howard brace

0%

2/629

Percutaneous repair with smooth Kirschner wires

1%

5/629

Open distal clavicle resection and transfer of the coracoacromial ligament

2%

10/629

Open reduction and internal fixation

93%

583/629

  • A

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The history and radiograph indicate a traumatic displaced distal clavicle fracture in a professional athlete. Open reduction and internal fixation provides the best chance to heal and retain shoulder function. Smooth Kirschner wires are at risk for migration, and acute acromioclavicular joint reconstruction with coracoacromial ligament transfer is unnecessary when there is good quality bone stock. Nonsurgical management may lead to a high chance of nonunion. Kenny-Howard braces may cause skin irritation and breakdown.

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