Influence of coracoclavicular heterotopic ossifications in treatment of clavicular fractures : Case report.

Abstract

Background: Heterotopic ossification (HO) arising from inflammatory processes often results in bony transformation of soft tissue. While the occurrence of HO is well-documented, its biomechanical influence on clavicular fractures remains less explored. We present a case report of a patient with a clavicular fracture following a bicycle accident, accompanied by incidental findings of HO around the coracoclavicular (CC) ligaments.

Case presentation: A 59-year-old man presented with a displaced right-sided clavicular fracture and a cervical vertebral body fracture following a bicycle fall. Incidental findings revealed pronounced HO around the CC ligaments. The patient underwent surgical stabilization for the cervical vertebral body fracture and clavicular fracture using open reduction and internal fixation. The presence of ossified CC ligaments may influence the biomechanical considerations for clavicular fractures.

Conclusion: The present case report suggests that ossified CC ligaments may impact clavicular biomechanics, potentially offering increased stability at the CC attachment and acting as a protective shield during trauma. This observation may indicate a possible predisposition to fractures in the clavicular region medial to the CC ligaments. While we cannot determine causality based on this single case, pronounced ossification of the CC ligaments could increase local stiffness and alter load distribution.