Retrosternal displacement of the clavicle after medial physeal fracture in an adolescent: MRI

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Retrosternal displacement of the medial clavicular metaphysis after a medial physeal fracture is a rare and potentially fatal injury because of possible damage of neurovascular structures, trachea and oesophagus. As the medial clavicular epiphysis does not ossify until 18–20 years of age and the medial clavicular physis is the last to close, around 22–25 years of age, this injury is difficult to demonstrate with plain radiographs in younger patients and is often mistaken for a sternoclavicular joint dislocation. We report on a 16-year-old boy with a fracture of the medial clavicular physis with retrosternal displacement of the metaphysis that was diagnosed with MRI, and discuss the diagnostic tools and treatment options in this rare injury.

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