Locking plates for displaced fractures of the lateral end of clavicle: Potential pitfalls
A 43-year-old right hand dominant male sustained an isolated fracture of the left lateral clavicle after a motorcycle accident in September 2009 []. The patient had ORIF using a lateral clavicle locking plate (Periloc, Smith and Nephew) to stabilize the fracture 1 week later [].\nFour weeks later the patient had a good range of movement but had a prominence over the lateral clavicle. Radiographs showed that the fracture was satisfactorily reduced but the acromioclavicular (AC) joint had subluxed. Radiographs taken on subsequent follow-up appointments showed that although the fracture had healed, the AC joint subluxation progressed to a dislocation []. The patient complained of ongoing shoulder pain and prominence of the lateral end of the clavicle.\nIn November 2010, the patient underwent removal of metalwork and stabilization of the AC joint. Intraoperative findings showed that the fracture had united but there was a Rockwood grade III dislocation of the AC joint. The AC joint was stabilized using a coracoclavicular sling [].\nSix weeks later the pain had improved. The range of movement was limited and the patient was referred for physiotherapy. Six months after the procedure, the patient had a full range of movement. However, the patient continued to experience some discomfort when lying on the left side and on heavy lifting. The OSS in December 2011 was 38.