A rare acromioclavicular joint injury in a twelve-year-old boy. A case report.

Injuries to the lateral part of the clavicle in a child with an immature skeleton are more likely to be physeal fractures than true acromioclavicular separations1,2. Nevertheless, lateral physeal separations of the clavicle and acromioclavicular joint dislocations do occur in children, and Dameron and Rockwood have classified these injuries according to six distinct types3. The combination of a physeal fracture with a ligamentous injury is even rarer and seems to violate the basic principle that a bone will fracture before a ligament will rupture in a child2. The aim of this case report is to remind the reader that, although this type of combined lesion can occur, it is often misdiagnosed or overdiagnosed; thus, an appropriate and careful evaluation must be performed so that unnecessary treatment can be avoided2. We report the case of a twelve-year-old boy who sustained an injury to the left acromioclavicular joint as a result of a fracture of the lateral part of the clavicle and a complete rupture of the coracoclavicular ligaments. This type of injury could not be categorized as any of the types in the classification system of Dameron and Rockwood3. This study was approved by the scientific review board at our hospital and was conducted in accordance with the World Medical Association Declaration of Helsinki of 1964, as revised in 1983. The parents of our patient were informed that data concerning the case would be submitted for publication, and they consented. Fig. 1 Standard anteroposterior radiograph of the left shoulder. Note the increased distance between the clavicle and both the acromion and the coracoid process. Fig. 2 The three-dimensional reconstruction of the computed tomography scan confirmed the fracture of the clavicle and …