Title: Fracture of the Medial Clavicle Mimicking Sternoclavicular Dislocation: The Diagnostic Value of CT and 3D Reconstruction
Authors: Jihad Radi, Hassan Mrani Alaoui, Anas Abaydi, Kamal Lahrach, Amine Marzouki, Fawzi Boutayeb
Volume: 10
Issue: 9
Pages: 47-50
Publication Date: 2026/09/28
Abstract:
Background: Fractures of the medial third of the clavicle are rare, accounting for less than 5% of all clavicular fractures, and are often difficult to distinguish clinically and radiographically from sternoclavicular joint dislocation. We report a case highlighting the diagnostic contribution of computed tomography (CT) and three-dimensional (3D) reconstruction in this setting. Case Presentation: A 69-year-old woman presented 2 hours after being struck by a motorcycle as a pedestrian, with isolated pain of the right shoulder. Clinical examination revealed tenderness and mild swelling over the right sternoclavicular region, without skin breach, ecchymosis, or vascular or neurological deficit. Standard anteroposterior chest radiographs raised suspicion of a sternoclavicular dislocation but did not allow a definitive diagnosis. CT with 3D reconstruction demonstrated a comminuted fracture of the medial third of the clavicle with anterior displacement of the main fragment, ruled out an underlying pneumothorax, and confirmed the absence of any retrosternal or vascular extension. In the absence of neurovascular complications, no contrast-enhanced CT was performed. The patient was treated conservatively with a sling immobilization. At the last clinical follow-up, she was pain-free with satisfactory function, though she declined further radiographic controls. Conclusion: CT with 3D reconstruction is a valuable tool in the diagnostic work-up of medial clavicle fractures, allowing accurate characterization of fracture pattern, displacement and comminution, differentiation from sternoclavicular dislocation, and exclusion of associated thoracic complications, thereby guiding therapeutic decision-making.