Surgical approach to malunion of midshaft clavicle fracture with ipsilateral acromioclavicular joint injury

The combination of midshaft clavicle fracture and ipsilateral acromioclavicular joint (ACJ) injury is rare, with few cases documented over the past three decades. Recent studies suggest a higher incidence of approximately 6.8% among clavicle fractures. Treatment approaches vary, but surgical interventions, such as double plate fixation and ligament repair, have shown promising functional outcomes. Risk factors include ipsilateral scapular body fractures. Standardized treatment protocols are yet to be established, but surgical management appears effective. This report presents a 40-year-old man with a 6-month-old malunited midshaft clavicle fracture and chronic AC joint separation, treated with corrective osteotomy and ligament reconstruction, highlighting the rationale for surgical intervention.