• Zhixiang Gao, Peng Cai, Kai Yao, Nengji Long, Lijuan Liu, and Cong Xiao.
• Department of Orthopedics, The Third Hospital of Mianyang Sichuan Mental Health Center, No. 190 The East Jiannan Road, Mianyang, China.
• Medicine (Baltimore). 2021 Nov 24; 100 (47): e27894e27894.

RationaleAcromioclavicular joint (ACJ) dislocation combined with ipsilateral midclavicular fracture is extremely unusual and is a high-energy injury to the shoulder. A review of the literature divides the treatment of clavicular fractures is divided into nonsurgical treatment, plates, and intramedullary nailing, while the options for ACJ dislocation are elastic fixation and rigid fixation. However, there is still a lack of consensus about the most appropriate way to treat this shoulder injury. This case report involves a mid-clavicle fracture with dislocation of the ipsilateral ACJ, which was classified as type V according to Rockwood classification.Patient ConcernsA 65-year-old man came to the emergency department after a traffic accident in which he was driving a motorcycle that collided with another motorcycle and his right shoulder collided directly with the ground. Digital radiography (DR) and computed tomography (CT) scans of the right shoulder joint showed mid-clavicle fracture with dislocation of the ipsilateral ACJ, which was classified as type V according to Rockwood classification.DiagnosesThe diagnosis of mid-clavicle fracture with dislocation of the ipsilateral ACJ was confirmed by DR and CT.InterventionsThe patient was treated with a clavicle plate combined with the double Endobutton technique.OutcomesAfter a 6-month follow up, the patient had excellent results for shoulder range of motion and functional. The patient's Constant-Murley score is 92.LessonsMid-clavicular fracture with a high-energy injury is highly suspicious and requires perfect shoulder CT or bilateral shoulder stress position DR to confirm whether there is a combined ACJ dislocation.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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