5: Distal Clavicle Fracture Dislocations

Neer classified fractures of the distal clavicle into two types depending upon whether the coracoclavicular ligaments were torn. The type I distal clavicle fracture did not have ligamentous injury and presented few problems long term. The type II distal clavicle fracture demonstrates displacement because of the detachment of the coracoclavicular ligaments. This fracture is lateral to the coracoid tubercle and it is the medial fragment that presents the problems. This fragment rides high, which leads to delayed union or nonunion and prolonged disability. A type III distal clavicle fracture was later described, consisting of an intraarticular fragment at the inferior joint surface of the clavicle.