{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:33:59Z","timestamp":1753893239390,"version":"3.41.2"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,5,28]],"date-time":"2021-05-28T00:00:00Z","timestamp":1622160000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:p>The pathophysiology of Horner's syndrome arises due to compression or destruction of the oculosympathetic nerve pathway. Traumatic Horner's syndrome may indicate lethal neurovascular injury, such as brain stem lesion, cervical spine injury, or carotid artery dissection. The middle-third is the most common type of clavicle fracture. However, the association of the isolated middle-third clavicle fracture and Horner's syndrome is rare. We report the case of a 47 year-old woman who presented to our emergency department with acute trauma. Severe tenderness and limited mobility were observed in her left shoulder. On radiographic examination, a middle-third clavicle fracture was diagnosed. Ptosis and myosis were also noticed on further examination, and she was subsequently diagnosed with Horner's syndrome. A survey of the brain, cervical spine, carotid artery, and lung revealed no pathological findings. Surgery for the clavicle fracture was performed 2 days after the accident. The patient recovered from Horner's syndrome gradually over the 2 months following the surgery, and the syndrome completely resolved by the third month. To the best of our knowledge, this is the first report of traumatic Horner's syndrome caused by an isolated middle-third clavicle fracture. The improved outcome may be attributed to the surgical intervention for middle-third clavicle fracture, which may help release ganglion or neuronal compression.<\/jats:p>","DOI":"10.3389\/fsurg.2021.640900","type":"journal-article","created":{"date-parts":[[2021,5,28]],"date-time":"2021-05-28T04:48:22Z","timestamp":1622177302000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Isolated Middle-Third Clavicle Fracture Causing Horner's Syndrome: A Case Report and Literature Review"],"prefix":"10.3389","volume":"8","author":[{"given":"Chia-Yu","family":"Lin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hao-Wei","family":"Chang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu-Hsuan","family":"Chang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I-Hao","family":"Lin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hung-Yu","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cheng-Hsien","family":"Chang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hsien-Te","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi-Wen","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsung-Li","family":"Lin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chin-Jung","family":"Hsu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,5,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1021\/acschemneuro.7b00405","article-title":"Horner syndrome: a clinical review","volume":"9","author":"Martin","year":"2018","journal-title":"ACS Chem Neurosci."},{"key":"B2","doi-asserted-by":"publisher","first-page":"W74","DOI":"10.2214\/AJR.05.1588","article-title":"Neuroimaging strategies for three types of Horner syndrome with emphasis on anatomic location","volume":"188","author":"Lee","year":"2007","journal-title":"Am J Roentgenol."},{"key":"B3","first-page":"428","article-title":"Painful Horner's syndrome revealing carotid artery dissection: about four cases","volume":"73","author":"Crahay","year":"2018","journal-title":"Rev Med Li\u00e8ge."},{"key":"B4","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1016\/j.jemermed.2008.01.017","article-title":"Horner syndrome due to carotid dissection","volume":"41","author":"Flaherty","year":"2011","journal-title":"J Emerg Med."},{"key":"B5","doi-asserted-by":"publisher","first-page":"e3382","DOI":"10.7759\/cureus.3382","article-title":"Horner syndrome due to spontaneous internal carotid artery dissection","volume":"10","author":"Shankar Kikkeri","year":"2018","journal-title":"Cureus."},{"key":"B6","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1016\/j.athoracsur.2012.03.114","article-title":"First rib fracture and Horner's syndrome: a rare clinical entity","volume":"95","author":"Ahmadi","year":"2013","journal-title":"Ann Thorac Surg."},{"key":"B7","doi-asserted-by":"publisher","first-page":"428","DOI":"10.5811\/westjem.2015.2.25336","article-title":"Horner's syndrome after superficial cervical plexus block","volume":"16","author":"Flores","year":"2015","journal-title":"West J Emerg Med."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1025","DOI":"10.1016\/j.ejcts.2003.09.014","article-title":"Horner's syndrome as a complication in thoracic surgical practice","volume":"24","author":"Kaya","year":"2003","journal-title":"Eur J Cardiothorac Surg."},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2016-217045","article-title":"Uncommon cause of Horner's syndrome","author":"Sugrue","year":"2016","journal-title":"BMJ Case Rep."},{"key":"B10","doi-asserted-by":"publisher","first-page":"bcr2015211705","DOI":"10.1136\/bcr-2015-211705","article-title":"Osteochondroma of the clavicle causing Horner's syndrome","volume":"2015","author":"Watura","year":"2015","journal-title":"BMJ Case Rep."},{"key":"B11","doi-asserted-by":"publisher","first-page":"e814","DOI":"10.3928\/01477447-20160517-06","article-title":"Midshaft clavicle fractures: a critical review","volume":"39","author":"Burnham","year":"2016","journal-title":"Orthopedics."},{"key":"B12","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1186\/s12891-017-1444-1","article-title":"Clavicle fractures: epidemiology, classification and treatment of 2 422 fractures in the Swedish Fracture Register; 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