{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T22:00:49Z","timestamp":1773698449229,"version":"3.50.1"},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2021,6,11]],"date-time":"2021-06-11T00:00:00Z","timestamp":1623369600000},"content-version":"vor","delay-in-days":161,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Clavicle fractures and acromioclavicular joint dislocations are very common injuries. However, the combination of both, known as \u201cfloating clavicle\u201d is extremely rare, with approximately 40 cases reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Presentation of case<\/jats:title>\n                    <jats:p>\n                      We report a case of a healthy 51-year-old male who suffered a high-velocity biking accident, with a bipolar clavicle injury (type IV acromioclavicular joint dislocation and proximal clavicle fracture), with concomitant rib fractures and pulmonary contusion. He received early surgical treatment by open reduction and osteosynthesis of the proximal clavicle (distal ulna plate,\n                      <jats:italic toggle=\"yes\">Protean<\/jats:italic>\n                      \u00ae) and open reduction and stabilization with a\n                      <jats:italic toggle=\"yes\">MINAR<\/jats:italic>\n                      \u00ae implant for the acromioclavicular joint. After an initial one-month immobilization, he started physical therapy. In the 10-month follow-up he presented with a pain-free full range of motion, a good cosmetic result, and radiological consolidation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Bipolar clavicle injury is a rare clinical entity that encompasses a spectrum of combined clavicle fractures, acromioclavicular or sternoclavicular joint dislocations. They are sustained in a high-energy context, and accompanying injuries must be sought. Diagnosis is made through X-Ray and CT. Despite the lack of clinical guidelines, most authors agree on surgical management of at least one of the injuries, with multiple surgical techniques available. There is an emphasis in surgical treatment of the young and active patient. Conservative treatment is associated with poorer results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>It is advisable to have a high index of suspicion for floating clavicle in a high-energy trauma patient, given possible life-threatening injuries, and long-term shoulder sequelae. Surgery should be considered in a young and active patient.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2021.106115","type":"journal-article","created":{"date-parts":[[2021,6,16]],"date-time":"2021-06-16T13:22:56Z","timestamp":1623849776000},"page":"106115","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":6,"title":["Floating clavicle after a high velocity biking accident"],"prefix":"10.1097","volume":"85","author":[{"given":"Irene Blanca","family":"Moreno-Fenoll","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Homero","family":"Valencia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Homid","family":"Fahandezh-Saddi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elsa","family":"Arruti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R3-2-20260114","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1007\/s11999-011-2049-x","article-title":"Case report: floating-clavicle from the 17th century: the oldest case?","volume":"470","author":"Liria","year":"2012","journal-title":"Clin. Orthop. Relat. Res"},{"key":"R4-2-20260114","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1016\/j.ijsu.2020.11.005","article-title":"The PROCESS 2020 guideline: updating consensus Preferred Reporting Of CasESeries in Surgery (PROCESS) guidelines","volume":"84","author":"Agha","year":"2020","journal-title":"Int. J. Surg"},{"key":"R5-2-20260114","first-page":"e7525","article-title":"Traumatic floating clavicle: is this a rare injury?","volume":"12","author":"Salmas","year":"2020","journal-title":"Cureus"},{"key":"R6-2-20260114","doi-asserted-by":"crossref","first-page":"316","DOI":"10.3928\/01477447-20110526-23","article-title":"Bipolar clavicular dislocation","volume":"34","author":"Argintar","year":"2011","journal-title":"Orthopedics"},{"key":"R7-2-20260114","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1177\/1758573214564496","article-title":"Segmental clavicle fracture and acromio-clavicular joint disruption: an unusual case report","volume":"7","author":"Marjoram","year":"2015","journal-title":"Should. Elb"},{"key":"R8-2-20260114","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1016\/j.ijscr.2017.10.025","article-title":"Bipolar fracture dislocation of clavicle: a report of osteosynthesis and early soft tissue reconstruction","volume":"41","author":"Prasetia","year":"2017","journal-title":"Int. J. Surg. Case Rep"},{"key":"R10-2-20260114","doi-asserted-by":"crossref","first-page":"57","DOI":"10.5704\/MOJ.1207.008","article-title":"Traumatic floating clavicle: a case report","volume":"6","author":"Choo","year":"2012","journal-title":"Malaysian Orthop. J"},{"key":"R11-2-20260114","first-page":"8888818","article-title":"The unique bipolar clavicle dislocation: a novel reconstruction technique and case report","volume":"2020","author":"Dev","year":"2020","journal-title":"Case Rep. Orthop"},{"key":"R12-2-20260114","first-page":"21","article-title":"Operative treatment of bipolar clavicular dislocation: a case report","volume":"2","author":"Schuh","year":"2012","journal-title":"J. Orthop. Case Rep"},{"key":"R13-2-20260114","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1097\/BOT.0b013e318205e215","article-title":"Traumatic floating clavicle: a case report","volume":"25","author":"Serra","year":"2011","journal-title":"J. Orthop. Trauma"},{"key":"R14-2-20260114","first-page":"12","article-title":"Traumatic floating clavicle-a case report","volume":"5","author":"Sopu","year":"2015","journal-title":"J. Orthop. Case Rep"},{"key":"R16-2-20260114","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1590\/S0102-36162011000500019","article-title":"Extra-articular fracture of the medial end of the clavicle associated with type IV acromioclavicular dislocation: case report","volume":"46","author":"Correa","year":"2011","journal-title":"Rev. Bras. Ortop"},{"key":"R17-2-20260114","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1177\/1758573214536534","article-title":"A rare case of floating clavicle and a novel technique for stabilizing the sternoclavicular joint","volume":"7","author":"Thyagarajan","year":"2015","journal-title":"Should. 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